Addressing Asthma by qga16183

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									  Addressing
   Asthma                       in Illinois




Illinois Department of Public Health   July 2002
Addressing
 Asthma
     in Illinois




  Illinois Department of Public Health


               July 2002
                                                                    July 2002




A
          n estimated 14.6 million persons in the United States suffer from
          asthma and its prevalence has been increasing over the past 20 years.
          In Illinois, which has one of the nation's highest mortality rates
          from asthma related causes, there were 279 deaths in 1999.

In addition to the physical toll exacted by asthma, its economic impact is
substantial. In 2000, direct expenditures related to asthma were estimated at
$8.1 million. In Illinois, direct expenditures totaled more than $1.4 million.

In 1999, more than 50 organizations joined the Illinois Department of Public
Health to form the Illinois Asthma Partnership. The group has grown and now
comprises more than 100 members, who, using a public health approach,
developed an asthma plan for Illinois. The plan's overarching goal is to reduce
asthma morbidity and mortality in Illinois through implementation of best
practices.

The Department extends its appreciation to those who served on the planning
committee and contributed their time and expertise to the development of the
Illinois Asthma Plan, Addressing Asthma in Illinois. Together, we can reduce
morbidity and mortality in Illinois and ensure a better quality of life for
persons with asthma.



                                             --Director of Public Health




                                      -3-
                                    Table of Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Scope of Problem Nationally . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Scope of Problem in Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
A Public Health Approach to Reducing the Burden of Asthma . . . .18
Goals and Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
      Data and Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
      Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
      Occupational Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
      Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
      State Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Implementation Guide               . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
      Data and Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
      Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
      Occupational . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
      Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
      State Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Sustaining Illinois' Asthma Initiatives . . . . . . . . . . . . . . . . . . . . . . .71



                                       Appendices
Appendix A
   Acronyms . . . . . . . . . . . .      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
Appendix B
   Healthy People 2010 . . . . . .       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
Appendix C
   Illinois Asthma Partnership List      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Appendix D
   Local Asthma Consortia . . . .        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Appendix E
   Local Asthma Consortia Map .          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Appendix F
   Illinois Call to Action . . . . . .   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86


                                                      -4-
                                      Tables Listing

Table 1
    Asthma Attacks     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Table 2
    Use of Health Care Services by Persons with Asthma . . . . . . . . . . . . . . . . . . .9
Table 3
    Emergency Department Visits for Asthma . . . . . . . . . . . . . . . . . . . . . . . . .9
Table 4
    Hospitalizations for Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Table 5
    Deaths from Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Table 6
    2000 BRFSS Demographic Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Table 7
    Discharge Rate from Acute Care Hospitals by Age Group - IL vs. US,1999            . . . . . . .14
Table 8
    Total Charges for Illinois Asthma Discharge, 1996-2000 . . . . . . . . . . . . . . . . . .14
Table 9
    Estimated Asthma Expenditures, 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Table 10
    Asthma Discharge Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Table 11
    Asthma Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Table 12
    Asthma Mortality for White population by Age Breakout . . . . . . . . . . . . . . . . .17
Table 13
    Asthma Mortality for Non-White population by Age Breakout . . . . . . . . . . . . . . .17
Table 14
    Asthma Mortality for All Races by Age Breakout . . . . . . . . . . . . . . . . . . . . . .17




                                                    -5-
                              Executive Summary



A
              sthma is a chronic lung disease associated with significant morbidity and
              mortality. Prevalence rates for asthma, particularly in children younger than 5
              years of age, have been increasing rapidly during the last decade. While the
              cause of asthma remains unknown, environmental agents and genetics seem to
              play a role. Currently, asthma is not preventable or curable, but it is
controllable. Although careful patient management would allow asthma to be successfully
treated on an outpatient basis, billions of dollars are spent annually on inpatient expenses for
persons with asthma.

Illinois has not escaped the burden of asthma. Indeed, the state has one of the nation's highest
mortality rates from asthma-related causes. The devastating impact of asthma in Illinois
paved the way for stakeholders across the state to form an Illinois Asthma Task Force in 1998.
Initially the task force responded to Public Act 91-0515, which directed the Illinois
Department of Public Health to develop a plan to address asthma, especially in high-risk
populations. This plan, Addressing Asthma in Illinois, was developed and presented to the
Illinois General Assembly in July 2000.

After receiving funds from the U.S. Centers for Disease Control and Prevention (CDC),
IDPH expanded on the initial task force to form the Illinois Asthma Partnership (Partnership).
During the first year of the CDC grant, partnership members were divided into four work
groups: Community and School, Data and Surveillance, Work Site, and Professional and
Patient Education. In the second year of the CDC grant, a partnership satisfaction survey
revealed a need for partners to assume more definitive leadership roles. In response, a
chairperson was selected for the partnership. During the third year of the CDC grant, the
work groups were reorganized to better address the compelling areas of need. These work
groups now include Data and Surveillance, Education, Occupational Asthma and School.

During the past three years, the work groups have successfully identified areas of need that
must be addressed if asthma is to be approached from a public health perspective and
appropriate strategies developed. The progress of the work groups and of the partnership's
leadership laid a foundation that allowed the initial asthma plan to develop into a
comprehensive state plan.

This state plan has been developed by the Illinois Asthma Partnership with the assistance of
work group members. Through implementation of the plan, Illinois will succeed in reducing
morbidity and mortality from asthma, thus reducing cost associated with the disease and
improving the quality of life for persons with asthma and persons who care for them.




                                               -6-
                        Scope of Problem Nationally



A
             sthma is one of this country's most common chronic conditions, affecting an
             estimated 14.6 million persons of all ages and races. In the past 20 years, the
             number of Americans with asthma has more than doubled. Tragically, the burden
             of asthma is most felt among specific populations, particularly among children and
             African Americans. Children under 5 years of age experienced the greatest increase
in asthma prevalence during this 20-year period.

Asthma affects 4.4 million children and is one of the leading causes of school absenteeism,
accounting for more than 10 million missed school days annually. Children with asthma miss an
average of twice as many school days as other children. Other nonquantifiable symptoms also may
impair quality of life for a child with asthma, for example, by restricting activities.

Among adults, asthma is the leading work-related lung disease. Keeping asthma under control is
expensive and imposes financial burdens -- including lost work days, lost income and lost job
opportunities -- on patients and their families. Asthma results in disruption to family and caregiver
routines.

Tracking the epidemiology of asthma by reviewing data related to prevalence, morbidity and
mortality is important because it provides information about several important issues:

       • how the United States health care system is doing in addressing the challenges
         posed by asthma;
       • progress in meeting Healthy People 2010 goals related to asthma; and
       • important benchmarks that local jurisdictions can use to compare their own
         progress in reducing the burden of lung diseases, specifically asthma.

In addition to growing prevalence rates, the occurrence of adverse asthma mortality and
hospitalization has been increasing. In 1998, in the United States, asthma accounted for more than 2
million emergency department visits, an estimated 423,000 hospitalizations and 5,438 deaths.

Asthma hospitalization is recognized by the public health system as conditions that can be used to
assess the stability of change in health levels of a population. Hospitalization is commonly
understood to be a marker for severe, uncontrolled or progressive disease, and is an important
predictor of subsequent asthma mortality.

Mortality from asthma remains an important public health issue, especially for certain populations,
such as inner-city African Americans. A review of the most recent national data can better describe
the burden of asthma for the country.




                                                   -7-
                          Asthma Attack Prevalence Rates

N
       ational data show that, in 1998, 39 people out of every 1,000 persons in the U.S. had
       experienced an asthma episode or attack in the previous 12 months. This represents
       about 10.6 million people. The following table provides a more comprehensive
breakdown of this figure.

                                                              Table 1
                                                         Asthma Attacks
                                            Crude Prevalence Rates for Asthma Attacks
      Crude Prevalence Rate for Asthma Attacks ........................................ 39/1,000 people
      (10.6 million people)

      Age
      Children ages 0-17......................................................................................53/1,000 people
      Adults ages 18 years and older ................................................................35/1,000 people

      Race/Ethnic Group
      Non-Hispanic whites .................................................................................39/1,000 people
      Non-Hispanic blacks..................................................................................50/1,000 people
      Hispanics .....................................................................................................36/1,000 people

      Gender
      Females ........................................................................................................44/1,000 people
      Males ............................................................................................................35/1,000 people

      Age/Gender
      Females, 0-17 years.....................................................................................41/1,000 people
      Males, 0-17 years ........................................................................................59/1,000 people
      Source: National Center for Health Statistics, United States Population, 1998



   Table 1 reports crude rates for prevalence of asthma attacks. When data are presented this
   way, it becomes possible to show the actual burden of asthma among subgroups of the
   population. To compare risk among groups (for example, those living in jurisdiction A vs.
   those residing in jurisdiction B), age-adjusted estimates of prevalence rates should be used.

   The 20-year asthma national trend data show the following:
         • asthma attack prevalence rates are 34 percent higher in children than in adults;
         • asthma attack prevalence rates in blacks are 22 percent to 28 percent higher
           compared to other racial/ethnic groups; and
         • asthma attack prevalence rates for all females are 21 percent higher than for males.
   However, the data also show that males ages 0-17 have an asthma attack prevalence rate that is
   31 percent higher than same-aged females.




                                                                             -8-
                                                     Table 2
                               Use of Health Care Services by Persons with Asthma
                                   Ambulatory/Outpatient Clinic Visits for Asthma

           Total ambulatory visits for asthma .................................515 visits/10,000 people
           (13.9 million visits)

           Age
           Ambulatory visits children ages 0-17 years.....................823 visits/10,000 people
           Ambulatory visits adults ages >17 years .........................407 visits/10,000 people

           Race
           Ambulatory visits, whites ..................................................463 visits/10,000 people
           Ambulatory visits, non-whites ..........................................778 visits/10,000 people

           Gender
           Females..................................................................................575 visits/10,000 people
           Males......................................................................................452 visits/10,000 people
Source: National Center for Health Statistics, United States Population, 1998




                                                        Table 3
                                         Emergency Department Visits For Asthma

           Total ED visits for asthma ..................................................76 visits/10,000 people
           (2 million visits)

           Age
           ED visits children ages 0-17 years.....................................124 visits/10,000 people
           (ED visits children ages 0-4 years) ....................................(170 visits/10,000 people)
           ED visits adults ages >17 years .........................................59 visits/10,000 people

           Race
           ED visits, whites...................................................................58 visits/10,000 people
           ED visits, non-whites ..........................................................204 visits/10,000 people

           Gender
           ED visits, females.................................................................82 visits/10,000 people
           ED visits, males ....................................................................69 visits/10,000 people
Source: National Center for Health Statistics, United States Population, 1998




                                                                          -9-
 Tables 4 and 5 continue to reflect the earlier prevalence profiles. Use of medical
 services for asthma related morbidity is higher among children, particularly those
 under 5 years of age, non-whites and females.

                                           Table 4
                              Hospitalizations for Asthma
 Total hospitalizations for asthma . . . . . . . . . . . . . .16 hospitalizations/10,000 people
 (423,000 hospitalizations)

 Age
 Hospitalizations*, children ages 0-17 years . . . . . . .25 hospitalizations/10,000 people
 (Hospitalizations*, children 0-4 years) . . . . . . . . . . .47 hospitalizations/10,000 people
 Hospitalizations*, adults ages >17 years . . . . . . . . .13 hospitalizations/10,000 people
 (*for asthma)

 Race
 Hospitalizations for asthma, whites . . . . . . . . . . . .10 hospitalizations/10,000 people
 Hospitalizations for asthma, non-whites . . . . . . . . .34 hospitalizations/10,000 people

 Gender
 Hospitalizations for asthma, females . . . . . . . . . . . .19 hospitalizations/10,000 people
 Hospitalizations for asthma, males . . . . . . . . . . . . .13 hospitalizations/10,000 people
 Source: National Center for Health Statistics, United States Population, 1998



                                                                   Table 5
                                                             Deaths from Asthma

  Total deaths from asthma . . . . . . . . . . . . . . . . . . . . . . . . . . 2 deaths/100,000 people
 (5,438 deaths; 6,850 deaths with asthma as a contributing cause)

 Age
 Deaths from asthma children ages 0-17 years . . . . . . . . . . 0.4 deaths/100,000 people
 Deaths from asthma adults ages >17 years . . . . . . . . . . . . . 2.6 deaths/100,000 people

 Race
 Deaths from asthma, non-Hispanic whites . . . . . . . . . . . . . 1.8 deaths/100,000 people
 Deaths from asthma, non-Hispanic blacks . . . . . . . . . . . . . 3.9 deaths/100,000 people
 Deaths from asthma, Hispanics . . . . . . . . . . . . . . . . . . . . . . 1.2 deaths/100,000 people

 Gender
 Deaths from asthma, females . . . . . . . . . . . . . . . . . . . . . . . . 2.5 deaths/100,000 people
 Deaths from asthma, males . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 deaths/100,000 people
Source: National Center for Health Statistics, United States Population, 1998




                                                                        - 10 -
Crude mortality rates for asthma present similar findings except in persons 17 years and
older, who experienced a higher mortality rate than the younger pediatric age group.

Data adjusted for age, race and sex that document the change in asthma prevalence
nationally have been published in the Morbidity and Mortality Weekly Report (MMWR),
"Self-reported asthma prevalence among adults" (2000). This report showed that the
self-reported prevalence rate for asthma increased 75 percent from 1980 to 1994. In
1993-1994, an estimated 13.7 million persons reported an asthma attack during the
preceding 12 months. This increasing trend in rates was evident among all race, both
sexes and all age groups with the most substantial increase occurring among children
ages 0-4 years (160 percent increase, from 22.2 per 1,000 to 57.8 per 1,000) and children
ages 5-14 years (74 percent increase from 42.8 per 1,000 to 74.4 per 1,000). The report
further verified that the increase in asthma prevalence rates during 1980-1994 was
evident in every region of the United States.

These data paint an alarming picture of asthma in the United States. In May 2000, a
panel convened by the U.S. Department of Health and Human Services to develop an
action plan to address asthma characterized the increasing trend in asthma prevalence
and adverse asthma outcomes as an epidemic.




                                            - 11 -
                       Scope of Problem In Illinois
                                  The Burden of Asthma in Illinois
The burden of asthma in Illinois follows national trends. Illinois, which has one of the high-
est asthma mortality rates in the nation, has seen an increase in prevalence, morbidity and
mortality over the past 20 years. The majority of the state's asthma deaths occur in the city
of Chicago and Cook County.

There are several data sources in Illinois that can be used to better understand the statewide
burden of asthma: the Behavioral Risk Factor Surveillance System (BRFSS), mortality data
from the Illinois Department of Public Health's Illinois Center for Health Statistics, and
hospital discharge data from the Illinois Health Care Cost Containment Council (IHCCCC).

The BRFSS is limited to non-institutionalized civilian adults over age 17. BRFSS data can be
used to estimate the prevalence of asthma and several other chronic diseases and associated
risk factors. In 2000, the BRFSS survey asked two question related to asthma.

          1. Have you every been told by a doctor or other health professional that
             you had asthma?

          2. Do you still have asthma?




                                                - 12 -
    The following table summarizes the demographic information from the 2000 BRFSS
for the entire state.
                                         Table 6
                             2000 BRFSS Demographic Data

       Age                         Percent                         Employment Status                 Percent
       Between 18 and 24 years old    18.4                         Employed                             58.8
       Between 25 and 34 years old    19.6                         Homemaker or student                 10.8
       Between 35 and 44 years old    21.0                         Out of work                           7.6
       Between 45 and 54 years old    17.2                         Retired/Unable to work               22.8
       Between 55 and 64 years old     7.6
       Over 65 years old              16.2                         Household Income
                                                                   Less than $10,000                     5.0
       Race                                                        Between $10,000 and $14,999           8.4
       White                             74.1                      Between $15,000 and $19,999           5.9
       Non-white                         25.9                      Between $20,000 and $24,999          11.8
                                                                   Between $25,000 and $34,999           8.6
       Hispanic Origin                                             Between $35,000 and $49,999          19.0
       Hispanic and have asthma           5.5                      Between $50,000 and $74,999          23.2
                                                                   More than $75,000                    18.1
       Gender
       Male                              28.7                      Urbanicity
       Female                            71.3                      Chicago                              21.2
                                                                   Suburban Cook County                 19.0
       Marital Status                                              Collar counties                      25.0
       Married & unmarried couple        52.8                      Urban counties                       13.6
       Divorced, widowed, or separated   19.2                      Rural counties                       21.2
       Never married                     28.0
                                                                   Smoking Status
       Education Level                                             Smoking at all                       59.9
       Elementary & some high school     10.2                      Not at all                           40.1
       High school graduate              27.6
       Some college                      31.2
       College graduate                  31.1            Source: IDPH Center for Health Statistics


It is estimated that almost 11 percent (10.7 percent or an estimated 979,600 people
[crude prevalence rate of 107 of every 1,000 adults]) of the adults in Illinois have
suffered or currently suffer from asthma. Of these persons who self-report doctor-
diagnosed asthma at some point in their lives, slightly more than three-quarters (75.1
percent) currently have asthma. These latter data show that almost 8 percent of adults
(7.9 percent or an estimated 724,500 people [crude prevalence rate of 79 of every 1,000
adults]) currently have asthma.

It is difficult to compare data taken from the statewide BRFSS with national data. A
lack of consensus between the reporting systems (e.g. in defining terminology) and the
use of crude prevalence rates make direct comparisons between Illinois data and
national data troublesome in assessing the impact of asthma on the state population.
However, this more detailed examination of the state BRFSS data is appropriate and
informative.




                                                - 13 -
Hospital discharge data on inpatient stays related to an asthma diagnosis are
collected through the Illinois Health Care Cost Containment Council (IHCCCC). Created in
1984 by the Illinois General Assembly, IHCCCC is mandated to collect and disseminate
information about the costs of hospital care in Illinois. The following tables, from the
Council's Asthma Hospital Guide 2000, emphasize the problem of asthma in Illinois.

                                                      Table 7
                              Discharge Rate from Acute Care Hospitals by Age Group
                                         Illinois vs. United States, 1999

      Age Group                                Ill Rate *                U.S. Rate*   % Difference
      Under 15                                   26.3                      31.5          -16.5%
      15-44                                      12.8                      10.0           23.0%
      45-64                                      18.2                      15.9           14.5%
      65 and over                                24.0                      21.2           13.2%
       *Rate per 10,000 population
       Source: Illinois Health Care Cost Containment Council


As the above data indicate, the rate of hospitalization is highest among the "under 15" and "65
and over" population. While the rate of hospitalization for the "under 15" age group was
lower in Illinois compared to the United States; all other age groups in Illinois showed higher
rates of hospitalization compared to those for the U.S.

                                                       Table 8
                               Total Charges for Illinois Asthma Discharge, 1996-2000
         1996                       1997               1998             1999            2000
     $181,665,968               $183,917,904       $174,468,752     $197,666,752    $187,026,144
        Source: Illinois Health Care Cost Containment Council


Table 8 details the growing cost of asthma treatment in Illinois hospitals.




                                                                - 14 -
The following table, based on national figures, shows the direct cost of asthma in Illinois.
In 2000, estimated cost of asthma treatments in Illinois was approximately $1.4 billion.
This includes all direct expenditures for inpatient and outpatient care.

                                                               Table 9
                                                 Estimated Asthma Expenditures, 2000

             Category                                         Cost (in millions)
                                                                  National                               Illinois (estimated)
             Direct Expenditures
             Hospital Care
                 Inpatient                                             $3,474.90                                $187.02*
                 Emergency Room                                          $656.10                                 $35.30
                 Outpatient                                             $421.20                                  $22.60

             Physician's Services
                Inpatient                                                $324.00                                 $17.30
                Outpatient                                               $769.50                                 $41.30

             Medications $2,446.20                            $1,316.67

             All Direct Expenditures                          $8,091.90            $1,433.17
             *actual amount from IHCCCC data
             Source: Illinois Health Care Cost Containment Council



As reflected in Table 10, inpatient charges for those discharged with a primary diagnosis of
asthma were $187 million in 2000. Asthma as a primary diagnosis accounted for 1.39 percent
of the discharges and 0.83 percent of all charges from Illinois hospitals in that year. Asthma
as a secondary diagnosis accounted for more than 3 percent of all stays and charges. IHCCCC
data show that asthma, as either a primary or secondary diagnosis, accounts for almost 5
percent of all Illinois inpatient stays and charges.

                                                                  Table 10
                                                          Asthma Discharge Data
      Type of Diagnosis      Total Charges                           % of Total Charges     Total Discharges   % of Total Discharges
      Asthma (primary)       $187,026,144                                  0.83%              22,796                        1.39%
      Asthma (secondary)     $832,116,736                                  3.68%              57,916                        3.54%
      Total Asthma         $1,019,142,880                                  4.51%              80,712                        4.93%
      All other inpatient $22,630,889,472                                95.49%            1,636,046                       95.70%
      Source: Illinois Health Care Cost Containment Council




                                                                          - 15 -
In summary, the IHCCCC's Asthma Hospital Guide 2000, paints the following picture of
asthma in Illinois.
    • Each year since 1996, females of all ages have accounted for more than half of all
      asthma discharges in Illinois.
    • Females were charged 17.9 percent more for their care than males in 2000; from
      1996-2000 the average charge for women increased 13.2 percent, average male charges
      increased 11.4 percent.
    • Medicaid patients had the highest average charge per discharge among all the other
      payor groups (Medicare, commercial, self-pay, other).
    • From 1996 to 2000, the number of stays for asthma as a primary diagnosis
      decreased, while stays for asthma as a secondary diagnosis increased.
    • From 1996 to 2000, 402 Illinois residents died while hospitalized for asthma.
    • While IHCCCC does not capture specific data on emergency department (ED)visits,
      hospitals do report each time a patient is admitted through the ED. From 1996 to 2000,
                    • The ED was the source of admission for 66.5 percent of asthma
                      hospitalizations.
                    • Physicians directly admitted 26.3 percent of asthma patients.

Tables 11-14 detail the mortality data related to asthma in Illinois from 1990 to 1999, with
age and race breakouts from 1990 to 1998.
                                                         Table 11
                                              Asthma Mortality

                                       Year               Number of Deaths
                                       1990                    248
                                       1991                    257
                                       1992                    259
                                       1993                    277
                                       1994                    308
                                       1995                    308
                                       1996                    271
                                       1997                    316
                                       1998                    293
                                       1999                    279*

                           *In 1999 mortality deaths were coded using ICD-10 and prior to 1999 using ICD-9.
                           Source: IDPH Center for Health Statistics.


Asthma mortality data by age group and race are available for 1990 to 1998. These data are
based on age specific death data rates per 1,000,000 population. Race is broken out by white
and non-white. Further breakdown in race is not possible due to small sample size.




                                                          - 16 -
                                                       Table 12
                                       Asthma Mortality, by age, Whites, 1990-1998

              Year        0-4          5-14      15-24   25-34    35-44   45-54   55-64   65-74   75-84    85+    All
              1990        1.5           1.6       3.8     6.1       5.6    12.3    26.4   60.7     77.8   179.2   17.1
              1991        1.5           3.1       3.1     3.7       6.8    14.2    24.2   35.9     96.9    95.1   14.8
              1992        2.9           2.3       3.9     4.4       8.1    15.4    20.7   46.8    103.8   171.7   17.4
              1993        1.4           2.3       3.9     5.8       5.9    12.0    14.7   56.4     88.9   146.9   16.1
              1994        1.4           2.3       5.6     9.7       7.7    18.0    17.2   61.0     90.8   133.9   18.4
              1995        0.0           2.3       2.4     8.6       7.0    16.6    29.6   61.3     98.8   210.8   20.1
              1996        1.4           2.2       6.4     6.1       6.3    12.7    22.3   52.2     62.9    89.3   14.9
              1997        1.4           3.7       4.0     2.8      12.4    18.9    25.7   44.6    109.1   180.0   19.6
              1998        0.0           2.2       5.5     3.5       4.3    14.3    16.3   33.4     75.2   165.1   14.3



          Source: IDPH Center for Health Statistics

                                                     Table 13
                                  Asthma Mortality, by age, Non-whites, 1990 - 1998

             Year         0-4        5-14       15-24    25-34    35-44   45-54   55-64   65-74   75-84    85+    All
             1990        10.4        14.0        28.2     33.6     41.0    68.7    93.7   105.9   115.7   416.7   42.8
             1991        15.1          8.3       28.3     61.8     59.4    76.9   135.8   146.3   269.7    77.5   56.8
             1992         9.8        21.8        20.1     31.6     38.9    67.0   101.2   156.4   176.6   148.1   44.8
             1993         9.6        29.5        39.9     51.5     62.8    68.3   120.8   186.5   126.8   137.9   58.0
             1994         0.0        21.4        47.8     80.5     55.5    78.8   113.4   155.3   189.1   135.1   61.1
             1995         4.7          7.9       33.5     61.2     45.0    70.5   148.8   177.3   144.6     0.0   52.5
             1996        18.9          5.2       41.9     50.3     65.7    90.2    99.1   190.1   203.3   192.3   58.4
             1997        14.4        20.4        19.4     75.4     65.1    67.4    96.9   140.5   283.4   189.9   57.7
             1998         4.8        35.7        27.6     94.8     82.4   105.9    67.8   161.8   240.5   246.9   69.4



          Source: IDPH Center for Health Statistics

                                                      Table 14
                                    Asthma Mortality, by age, All Races, 1990 - 1998

              Year        0-4          5-14      15-24   25-34    35-44   45-54   55-64   65-74   75-84    85+    All
              1990        3.4           4.3       8.9     11.1     11.7    21.5    36.0    65.9    81.3   198.8   21.7
              1991        4.5           4.2       8.5     14.2     15.8    24.5    40.3    48.7   113.0    93.6   22.3
              1992        4.4           6.6       7.4      9.2     13.4    24.0    32.3    59.6   110.5   169.6   22.3
              1993        3.3           8.3      11.7     14.1     15.8    21.5    30.3    71.6    92.5   146.0   23.7
              1994        1.1           6.5      14.9     22.8     16.0    28.3    31.4    72.1   100.2   134.0   26.2
              1995        1.1           3.5       9.3     18.3     13.6    26.0    47.3    75.0   103.2   191.6   26.0
              1996        5.5           2.9      14.3     14.4     16.6    26.0    33.8    68.5    76.5    98.6   22.9
              1997        4.4           7.4       7.4     16.4     21.5    27.2    36.3    55.9   125.8   180.9   26.6
              1998        1.1           9.6      10.3     20.7     17.6    29.7    23.9    48.6    90.8   172.2   24.3



          Source: IDPH Center for Health Statistics



The data from the BRFSS, IHCCCC, and the IDPH's Center for Health Statistics clearly indi-
cate the burden of asthma in Illinois and the need to address asthma, in order to reduce mor-
bidity and mortality.




                                                                 - 17 -
                   A Public Health Approach to
                  Reducing the Burden of Asthma
Within the health care field, the concept of "adopting a public health approach" to reduce the
burden or impact of a disease or condition has emerged over the past 15 years. For purposes
of this asthma plan, a public health approach would suggest adopting "a broad, multi-
disciplinary perspective that is concerned with improving outcomes in all people who have
asthma with attention to equity and the most efficient use of resources in ways that enhance
patient and community quality of life.”

Public health interventions, like the one proposed for Illinois' asthma state plan, focus on
community rather than on an individual. These population-based interventions operate at
three levels: preventing asthma (primary prevention), preventing disability from asthma in
those who have the condition (secondary prevention, or reducing the impact) and limiting
further deterioration or death (tertiary prevention, or reducing the consequences).

Rather than focusing on questions of appropriate treatment for someone with asthma,
practitioners adopting a public health approach would look for methods or strategies that
promised the maximum benefit for the largest number of people. It is important to
recognize that the public health approach does not abandon care of individual patients.
Instead it broadens the reach of the health care system to include all persons, particularly,
those who might be designated as underserved.

In adopting a public health approach to reducing the burden of asthma, the Illinois Asthma
Partnership also has incorporated the core functions of public health systems into the
structure of its state plan:

      1. Assessment and monitoring of the health of communities and populations at risk to
         identify health problems and priorities;
      2. Assuring that all populations have access to appropriate and cost-effective care,
         including health promotion and disease prevention services, and that the
         effectiveness of that care is effectively evaluated;
      3. Formulating public policies, in collaboration with community and government
         leaders, designed to solve identified local and national health problems and
         priorities.

Illinois' asthma plan is built on this core functions model. For example, the Data and
Surveillance Work Group, in conjunction with the Illinois Asthma Partnership has focused on
assessment (systematic collection, analysis and distribution of information on the burden of
asthma in Illinois). The School Work Group and the Occupational Asthma Work Group have
emphasized projects related to assurance (determining and prioritizing asthma services and
ensuring that the population receives the services needed). In addition to incorporating the
first two functions, the Education Work Group has also focused on the policy function by
promoting the use of scientific knowledge as a basis for public health decisions related to
reducing the burden of asthma.


                                              - 18 -
                            Goals and Strategies
The following five priority areas were identified through the Illinois Asthma Partnership’s
strategic planning process. They include data and surveillance, education, occupational asth-
ma, schools, and state coordination. Within each of these priority areas, goals have been iden-
tified that incorporate the three core functions of public health. The strategies identified are
the interventions that will be used to achieve the goals identified.

Data and Surveillance

Focus: Obtain scientific information related to asthma in Illinois; disseminate the
information to those who are interested and who need to know; promote the use of
scientific information as the foundation for action in alleviating the burden of asthma in
Illinois; and evaluate the usefulness of this information for program development and
implementation.

   1. Goal
        Improve asthma surveillance in Illinois.
        Strategies
               1. Identify or create an asthma specific data collection and evaluation
                  component within a state agency.
               2. Identify or develop a list of potential partners/stakeholders to be involved
                  in community surveillance efforts.
               3. Identify and monitor community health indicators related to asthma.
               4. Identify environmental (occupational, urban, etc.) asthma health indicators.
               5. With the Occupational Asthma work group, develop work-site surveillance
                  systems.

   2. Goal
        Analyze and compare asthma data including prevalence by sex, race, ethnic group,
        age and other identified variables (income, education, occupation) in Illinois and in
        the U.S.
        Strategies
               1. Monitor changes in prevalence and its impact.
               2. Identify disparities in asthma burden and access to care in targeted
                  populations in Illinois.
               3. Working within the framework of the Illinois Asthma Partnership, promote
                  collaborative and comparative studies that identify factors responsible for
                  wide variation of prevalence of asthma in different school districts or
                  industries and occupations in Illinois.




                                             - 19 -
3. Goal
     Ensure standard and consistent use of terms related to asthma and surveillance of
     asthma in Illinois.
     Strategies
            1. Work with professionals to develop consensus on definition of asthma and
               on definitions of surveillance measures, including identifying and adopting
               nationally accepted terms used in asthma surveillance and research.
            2. Create a task force to develop a classification system for asthma to ensure
               that etiologic information is better captured.
            3. With the Education Work Group, study medical referral systems and access
               to different types of medical care, especially targeting vulnerable
               demographic groups.
            4. Develop environmentally specific terminology (occupational, urban, etc.)

4. Goal
     Develop or utilize existing planned population-based longitudinal data systems and
     existing information sources to track the occurrence, progression and impact of
     asthma for persons in Illinois.
     Strategies
            1. Use inventory of statewide and local past and current research studies and
               databases that can supplement knowledge gaps.
            2. On an ongoing basis, with the Education Work Group, survey providers on
               treatment strategies used and on their beliefs about asthma.
            3. On an ongoing basis, with the Occupational Asthma Work Group, collect
               and analyze more detailed state-level information on occupational factors in
               the development of asthma.
            4. Support existing studies and work to initiate new studies where needed
               that would address disability from asthma, natural history of asthma and
               risk factors for exacerbation.
            5. Incorporate state of Illinois data into national tracking systems.

5. Goal
     Identify modifiable risk factors, particularly in the community and workplace,
     leading to a reduction in the incidence, morbidity and mortality associated with
     asthma in Illinois.
     Strategies
            1. Solicit information on co-morbid conditions.
            2. Identify different risk factors for asthma in definable population subgroups.
            3. Identify barriers to environmental modification that people with asthma
               may face.
            4. Expand state agency involvement to address asthma-related factors.




                                         - 20 -
6. Goal
     Estimate the cost of asthma in Illinois.
     Strategies
            1. Review data on the cost effectiveness of a variety of interventions
               particularly chronic disease self-management strategies.
            2. Develop a strategy to assemble a comprehensive list of indirect and direct
               costs of asthma and determine the total cost.




                                         - 21 -
Education

Focus: Promote the National Heart, Lung and Blood Institute (NHLBI) guidelines;
promote asthma training for health care professionals statewide who work with asthma
patients; and promote best practices.

   1. Goal
        Promote asthma training for health care professionals statewide who work
        with asthma patients.
        Strategies
               1. Identify target population, especially primary care physicians (such as
                  pediatricians, family practice physicians, internists), emergency
                  physicians, nurse practitioners and physician assistants to receive
                  asthma training.
               2. Identify asthma experts who will provide training based on the NHLBI
                  guidelines.
               3. Identify quality improvement experts to assist trainers in providing high
                  quality asthma training.
               4. Provide asthma training for health care professionals (such as nurses, nurse
                  practitioners, respiratory therapists, physician assistants) who will serve as
                  asthma educators and improve the system of asthma care in their setting.

   2. Goal
        Disseminate the National Heart Lung and Blood Institute (NHLBI) guidelines across
        the state.
        Strategies
               1. Promote NHLBI guidelines on the IDPH Web site.
               2. Disseminate NHLBI guidelines during workshops with target populations.

   3. Goal
        Facilitate provision of asthma education statewide for asthma patients and care
        givers of people with asthma.
        Strategies
                1. Identify and promote effective asthma self-management programs, based
                   on the NHLBI guidelines, with emphasis on high-risk populations.
                2. Develop and promote effective education for care givers of people with
                   asthma, including identification and management of asthma emergencies.
                3. Provide asthma training for health care professionals (such as nurses,
                   nurse practitioners, respiratory therapists, physician assistants) who will
                   serve as asthma educators.
                4. Provide asthma training for community health workers and peer
                   educators who will serve as asthma educators.




                                             - 22 -
4. Goal
     Promote asthma awareness, education and screening programs in communities
     across the state.
     Strategies
            1. Identify effective asthma outreach strategies for communities and local
               asthma experts who will provide education and/or screening.
            2. Identify effective asthma educational materials and resources that promote
               the NHLBI guidelines, including materials geared toward low literacy,
               multiple languages and cultural competence.
            3. Establish a clearinghouse for asthma information based on the NHLBI
               guidelines.




                                         - 23 -
Occupational Asthma

Focus: Work with epidemiology specialists to determine the burden of asthma in the
workplace; work through local or regional public health agencies to provide information to
local businesses that address asthma as a public health issue in the workplace; use
businesses, directly or indirectly through insurance carriers, as important sites for the
distribution of resource materials related to prevention of asthma in the workplace; ensure
that people affected by asthma in the work place receive the support and services they
need.

   1. Goal
        Increase awareness of asthma, including its impact, the importance of early
        diagnosis and appropriate management, and the availability of effective treatment
        and prevention strategies, in working adults in Illinois.
        Strategies
               1. Develop a solid knowledge base on prevention of asthma in the workplace
                  that can be shared with health care professionals working in industry.
               2. Develop a solid knowledge base on asthma in the workplace that can be
                  shared with primary care providers to allow them to more effectively
                  educate patients who work in high-risk industries.
               3. Work within Illinois communities to help identify and target those
                  business/industrial environments that have high asthma prevalence rates.
               4. Identify "best practices" locally, statewide and nationally that prevent the
                  development of asthma or workplace exacerbations of asthma.

   2. Goal
        Identify effective methods of accommodation in the workplace for persons with
        asthma and similar methods of accommodation and change to help prevent
        employees from developing asthma through a bench marking process.
        Strategies
               1. Develop consistent asthma messages that are designed to reach specific
                  employee populations, particularly those designated as underserved.
               2. Become a clearinghouse for the latest public information on occupational
                  asthma.
               3. Work with insurers to develop programs that will help make
                  employee-based health care systems more responsive and better able
                  to meet the needs of working people with asthma.




                                            - 24 -
3. Goal
     Increase awareness among administration, management and human resource
     personnel in businesses throughout Illinois on occupational asthma, including risk
     factors, impact, prevention strategies and management.
     Strategies
            1. Develop a list of Illinois industries that have high asthma prevalence rates
               and distribute to local health departments to allow staff to identify
               businesses in their areas that can be targeted for health education messages
               related to asthma in the workplace.
            2. Coordinate with the IDPH’s Division of Environmental Health to
               educate businesses regarding integrated pest management (IPM) and other
               techniques that reduce worker exposure to potential risk factors.

4. Goal
     Coordinate services or recommend services related to monitoring and improving the
     workplace environment.
     Strategies
            1. Develop and market an occupational tool kit that includes a list of
               resources businesses may contact to undertake workplace environment
               monitoring.
            2. Work with state and federal enforcement agencies to develop a list of
               businesses with issues related to environmental quality and distribute
               educational material to those businesses.
            3. Develop a mechanism to provide public recognition to businesses that
               improve the workplace environment.

5. Goal
     Work with the Illinois Asthma Partnership to advocate for the development of
     adequate programs for health care insurance coverage, disability insurance coverage
     and retraining for workers affected by occupational asthma.
     Strategies
            1. Provide information to human resource personnel to accommodate
               persons who may need job retraining to avoid exposure to
               occupational asthma risk factors.
            2. Identify current health care and disability insurance programs for
               occupational asthma in Illinois.
            3. Partner with federal and state enforcement agencies to develop programs
               that protect workers and make the workplace environment safe.




                                         - 25 -
Schools

Focus: Provide effective asthma educational materials and resources to school nurses,
teachers, administrators, other professionals and all other school personnel, including but
not limited to secretaries, security, maintenance, dietary, bus drivers, lunch and playground
staff; promote a consistent message to the school community on the management of asthma;
increase awareness about asthma among school personnel, parents and students; provide
school staff with the necessary tools to develop strategies and policies that support the
whole school community throughout the educational continuum, including day care
through college, in the management of asthma.

   1. Goal
        Encourage all schools to obtain an appropriate written action plan for every child
        with asthma.
        Strategies
               1. Work with appropriate organizations and the Education Work Group to
                  develop effective educational programs regarding asthma action/
                  management plans based on the National Heart, Lung and Blood
                  Institute (NHLBI) guidelines.
               2. Encourage school districts to establish a team of school personnel to ensure
                  an appropriate written action plan for each child with asthma.

   2. Goal
        Support appropriate continuing education in asthma management for school
        personnel.
        Strategies
               1. Encourage providers of continuing education programs for teachers,
                  education administrators and school nurses to include asthma as part of the
                  curriculum.
               2. Encourage teacher and education administration students to take a course
                  in health and safety as part of their college training.
               3. Promote continuing asthma education for all school nurses (day care
                  through college).
               4. Continue to provide an annual satellite conference for administrators,
                  personnel, children and families on issues related to asthma in the schools.
               5. Implement evidence based programs related to asthma for school staff.

   3. Goal
        Support the development of indoor air quality and environmental improvements in
        schools.
        Strategies
               1. Identify effective indoor air quality assessment methods.
               2. Provide information about indoor air quality to schools.
               3. Work with school districts to identify potential funding sources to
                  implement indoor air quality and environmental improvements.



                                            - 26 -
4. Goal
     Encourage schools to comply with the state's asthma medication law, (P.A. 92-0402).
     Strategies
            1. Provide information about the asthma medication law to all school
               personnel.
            2. Provide information about the asthma medication law to the Illinois School
               Nurses Association, school personnel organizations and associations
               (including teachers, secretaries and bus drivers), parents and guardians,
               college educators and day care providers.

5. Goal
     Advocate for asthma education certification for school nurses, coaches and physical
     education teachers.
     Strategies
            1. Identify appropriate certification programs.
            2. Develop a plan of action to implement certification programs.
            3. Mandate asthma education certification for school nurses, coaches and
               physical education teachers.

6. Goal
     Improve access to asthma educational materials and asthma medications and
     supplies for schools.
     Strategies
            1. Encourage schools to ensure that teachers, parents and students have access
               to education on asthma.
            2. Provide asthma information and resources to schools, day care workers and
               colleges through collaboration with the Illinois State Board of Education,
               the Illinois Department of Human Services and school networks.
            3. Enhance knowledge of school personnel on proper use of asthma
               equipment (peak flow meters, nebulizers, spacers).
            4. Work to identify funding sources for schools to obtain asthma medications
               and supplies to schools.
            5. Advocate for health care insurance coverage for school-based asthma
               medications and supplies (inhaler, spacer, nebulizer, peak flow meter, and
               asthma education).




                                         - 27 -
State Coordination

Focus: Link asthma initiatives with other chronic disease and environmental initiatives;
build on existing co-morbidity projects; and enhance asthma initiatives through other
chronic disease and environmental venues.

   1. Goal
        Expand Illinois Asthma Partnership to include organization/agencies not
        currently involved but which serve the same or similar target populations,
        address asthma or have the potential to address asthma.
        Strategies
               1. Identify target audiences for work groups and projects.
               2. Identify organizations and agencies that work with target populations or
                  address asthma (such as inner city clinics, asthma clinics, youth
                  foundations).
               3. Identify organizations and agencies with linkages to target populations
                  that do not focus on asthma (for example, tobacco cessation programs).

   2. Goal
        Implement and evaluate a pilot project for chronic disease management based on a
        comprehensive case management approach that relies on public health nursing.
        Strategies
               1. Define case management.
               2. Identify existing asthma case management programs and develop linkages.
               3. Educate public health nurses in case management programs about
                  techniques to address asthma.

   3. Goal
        Promote the development and/or recruitment of certified asthma educators in
        community settings to increase patient education.
        Strategies
               1. Promote nationally recognized training in asthma education as the
                  standard for asthma educators.
               2. Identify nationally certified asthma educators who can serve as resources
                  for communities in need.

   4. Goal
        Obtain additional funding to support the state's asthma plan.
        Strategies
               1. Identify areas within the plan that need funding to implement strategies.
               2. Identify potential sources of funding.
               3. Develop linkages with potential funding sources.




                                            - 28 -
5. Goal
     Establish a steering committee to oversee and evaluate the progress of the state's
     asthma plan.
     Strategies
            1. Identify criteria for committee membership.
            2. Identify and recruit members for steering committee.
            3. Convene steering committee at regular intervals to assess progress of the
               state plan.




                                         - 29 -
                                 Implementation Guide
The implementation guide elaborates on the goals and strategies by providing detail for the
strategies identified for each goal and to assist with implementation of the strategy. The user
will have a more clear understanding of who the target audience is, who will be responsible
for completion of the strategy, what resources are needed to implement the strategy,
evaluation indicator, what are potential barriers to implementation, who else could assist
with implementation of the strategy and how long it is expected to implement the strategy.


   Data and Surveillance

   1. Goal. Improve asthma surveillance in Illinois.

        Strategy 1. Identify or create an asthma specific data collection and evaluation
                        component within a state agency.

     Target      Responsible      Anticipated        Measurable       Anticipated    Collaborators           Time
   Population      Person          Resources          Indicator         Barriers                            Frame

   Who is the      Who will          What is         How will you     What issues       Who else          How long
    primary         do it?          needed?          show it was      need to be       should be           will the
   audience?                                         completed?       addressed?       involved?        project take?



  Illinois       Data and        Data and           Specific         Time, buy-in    State              1 year
  Asthma         Surveillance    evaluation         collection and                   epidemiologist
  Partnership    Work Group      tools, time        evaluation
                                                    component
                                                    identified or
                                                    created



        Strategy 2. Identify or develop a list of potential partners/stakeholders to be involved in
                        community surveillance efforts.

      Target      Responsible      Anticipated        Measurable       Anticipated   Collaborators           Time
    Population      Person          Resources          Indicator         Barriers                           Frame

    Who is the      Who will         What is         How will you      What issues      Who else          How long
     primary         do it?         needed?          show it was       need to be      should be           will the
    audience?                                        completed?        addressed?      involved?        project take?



  Illinois        Data and       Time,              List of          Identifying     Partnership,
  Asthma          Surveillance   materials to       stakeholders     potential       community-         1 year
                                 survey persons     identified       stakeholders    based agencies,
  Partnership     Work Group     on types of data                                    local asthma
                                 now collected or                                    consortia, local
                                 that could be                                       health
                                 collected                                           departments
                                                                                     (LHDs)




                                                         - 30 -
      Strategy 3. Identify and monitor community health indicators related to asthma.

    Target     Responsible      Anticipated          Measurable          Anticipated      Collaborators         Time
  Population     Person          Resources            Indicator            Barriers                            Frame

 Who is the      Who will          What is           How will you        What issues         Who else         How long
  primary         do it?          needed?            show it was         need to be         should be          will the
 audience?                                           completed?          addressed?         involved?       project take?



Illinois       Data and        Linkages to          Health indicators   Time, access to   LHDs,             1 year
Asthma         Surveillance    communities,         identified          resources to      community-
Partnership    Work Group      list of indicators                       identify health   based agencies,
                                                                        indicators,       local asthma
                                                                        decision on       consortia
                                                                        indicators



      Strategy 4. Identify environmental (occupational, urban, etc.) asthma health indicators.

   Target      Responsible      Anticipated          Measurable          Anticipated      Collaborators         Time
 Population      Person          Resources            Indicator            Barriers                            Frame

 Who is the      Who will          What is           How will you        What issues         Who else         How long
  primary         do it?          needed?            show it was         need to be         should be          will the
 audience?                                           completed?          addressed?         involved?       project take?



Illinois       Data and        Access to            Health              Time, access to   LHDs,             1 year
Asthma         Surveillance    databases and        indicators          resources to      community-
Partnership    Work Group      information to       identified          identify health   based agencies,
                               identify health                          indicators,       local asthma
                               indicators                               consensus on      consortia,
                                                                        indicators        industries



      Strategy 5. With the Occupational Asthma Work Group, develop work-site surveillance
                    systems.

    Target     Responsible      Anticipated          Measurable          Anticipated      Collaborators         Time
  Population     Person          Resources            Indicator            Barriers                            Frame

 Who is the      Who will          What is           How will you        What issues         Who else         How long
  primary         do it?          needed?            show it was         need to be         should be          will the
 audience?                                           completed?          addressed?         involved?       project take?



Illinois       Data and        Time, access to      Surveillance        Access to         Business,         4 years
Asthma         Surveillance    work-sites,          systems             work-sites,       industries,
Partnership    Work Group,     systems design       developed           buy-in            unions, local
               Occupational                                                               health
               Asthma Work                                                                departments
               Group




                                                         - 31 -
     2. Goal.      Analyze and compare asthma data, including prevalence by
                   sex, race, ethnic group, age and other identified variables
                   (income, education, occupation) in Illinois and in the U.S.

      Strategy 1. Monitor changes in prevalence and its impact.

   Target      Responsible       Anticipated    Measurable       Anticipated     Collaborators           Time
 Population      Person           Resources      Indicator         Barriers                             Frame

 Who is the      Who will          What is      How will you     What issues        Who else           How long
  primary         do it?          needed?       show it was      need to be        should be            will the
 audience?                                      completed?       addressed?        involved?         project take?



Illinois       Data and         National and   Report on        Access to data   Data sources        Annually
Asthma         Surveillance     state data     difference of
Partnership    Work Group                      national and
                                               state data




     Strategy 2. Identify disparities in asthma burden and access to care in targeted populations in
                    Illinois.

   Target      Responsible       Anticipated    Measurable       Anticipated     Collaborators           Time
 Population      Person           Resources      Indicator         Barriers                             Frame

 Who is the      Who will          What is      How will you     What issues        Who else           How long
  primary         do it?          needed?       show it was      need to be        should be            will the
 audience?                                      completed?       addressed?        involved?         project take?



Illinois       Data and         National and   Report on        Access to data   Data sources,       2 years
Asthma         Surveillance     state data     disparities in                    community-
Partnership    Work Group                      targeted                          based agencies
                                               populations                       serving disparate
                                                                                 target
                                                                                 populations




                                                    - 32 -
     Strategy 3. Working within the framework of the Illinois Asthma Partnership, promote
                      collaborative and comparative studies that identify factors responsible for
                      wide variation of prevalence of asthma in different school districts or
                      industries and occupations in Illinois.

    Target      Responsible       Anticipated         Measurable         Anticipated     Collaborators          Time
  Population      Person           Resources           Indicator           Barriers                            Frame

  Who is the      Who will          What is           How will you       What issues        Who else         How long
   primary         do it?          needed?            show it was        need to be        should be          will the
  audience?                                           completed?         addressed?        involved?       project take?



Illinois        Data and        Time, survey         List of factors    Linkages to      Illinois Asthma   2 years
Asthma          Surveillance    tools                identified,        identify         Partnership,
Partnership     work group                           studies designed   factors,         School and
                                                                        databases to     Occupational
                                                                        access           Asthma Work
                                                                        information      Groups



     3. Goal. Ensure standard and consistent use of terms related to asthma
              and the data surrounding surveillance of asthma in Illinois.
     Strategy 1. Work with professionals to develop consensus on definition of asthma and
                     on definitions of surveillance measures, including identifying and adopting
                     nationally accepted terms used in asthma surveillance and research.

   Target       Responsible      Anticipated          Measurable         Anticipated     Collaborators         Time
 Population       Person          Resources            Indicator           Barriers                           Frame

 Who is the       Who will          What is           How will you       What issues        Who else         How long
  primary          do it?          needed?            show it was        need to be        should be          will the
 audience?                                            completed?         addressed?        involved?       project take?



Illinois        Data and        Linkages to          Consensus on       Consensus,       Health care       2 years
Asthma          Surveillance    healthcare           definitions and    buy-in,          professional
Partnership,    Work Group      professionals,       measures,          agreement of     organizations,
health care                     listing of current   nationally         nationally       Illinois Asthma
professionals                   definitions and      accepted terms     accepted terms   Partnership
                                nationally           adopted
                                accepted terms




                                                          - 33 -
     Strategy 2. Create a task force to develop a classification system for asthma to ensure
                        that etiologic information is better captured.

   Target         Responsible       Anticipated         Measurable          Anticipated        Collaborators           Time
 Population         Person           Resources           Indicator            Barriers                                Frame

 Who is the         Who will          What is           How will you        What issues           Who else           How long
  primary            do it?          needed?            show it was         need to be           should be            will the
 audience?                                              completed?          addressed?           involved?         project take?



Illinois          Data and         Glossary of         Task force          Buy-in to use of    Illinois Asthma     1 year
Asthma            Surveillance     terms from          developed,          system/terms        Partnership,
Partnership       work group       professional        classification                          LHDs,
                                   groups              system                                  community-
                                                       developed                               based agencies,
                                                                                               local asthma
                                                                                               consortia


     Strategy 3. With the Education Work Group, study medical referral systems and access
                        to different types of medical care, especially targeting vulnerable demo-
                        graphic groups.

    Target         Responsible      Anticipated         Measurable          Anticipated        Collaborators           Time
  Population          Person         Resources           Indicator            Barriers                                Frame

 Who is the          Who will          What is          How will you        What issues           Who else           How long
  primary             do it?          needed?           show it was         need to be           should be            will the
 audience?                                              completed?          addressed?           involved?         project take?



Illinois          Data and         Collaboration       Report on           Identification of   Community orga-     4 years
Asthma            Surveillance     between the work    referral systems    referral systems,   nizations and
Partnership       Work Group and   groups,             and access to       modeling and        agencies, local
                  Education Work   identification of   medical care in     stochastic          asthma consor-
                  Group            current referral    vulnerable          processes to        tia, local health
                                   systems             demographic         determine           departments
                                                       groups              outcomes


     Strategy 4. Develop environmentally specific terminology (occupational, urban, etc).

    Target        Responsible        Anticipated         Measurable          Anticipated        Collaborators           Time
  Population        Person            Resources           Indicator            Barriers                                Frame

  Who is the        Who will           What is           How will you        What issues           Who else          How long
   primary           do it?           needed?            show it was         need to be           should be           will the
  audience?                                              completed?          addressed?           involved?        project take?



Illinois Asthma   Data and         List of current     List of             Agreement on        Occupational        1 year
Partnership       Surveillance     terminology         terminology and     terminology and     Asthma Work
                  Work Group                           issues identified   issues              Group
                                                       for use




                                                            - 34 -
     4. Goal.     Develop or utilize existing planned population-based
                  longitudinal data systems and existing information sources to
                  track the occurrence, progression and impact of asthma for
                  persons in Illinois.
     Strategy 1. Use inventory of statewide and local past and current research studies and
                    databases that can supplement knowledge gaps.

    Target     Responsible       Anticipated       Measurable         Anticipated   Collaborators        Time
  Population     Person           Resources         Indicator           Barriers                        Frame

 Who is the      Who will           What is        How will you       What issues      Who else        How long
  primary         do it?           needed?         show it was        need to be      should be         will the
 audience?                                         completed?         addressed?      involved?      project take?



Illinois       Data and         Databases         List of studies    Access to      Local health     2 years
Asthma         Surveillance                       and databases      studies and    departments,
Partnership    work group                         identified and     databases      state agencies
                                                  used to
                                                  supplement
                                                  knowledge gaps



     Strategy 2. On an ongoing basis, with the Education Work Group, survey providers on
                   treatment strategies used and on their beliefs about asthma.

   Target      Responsible       Anticipated       Measurable         Anticipated   Collaborators        Time
 Population      Person           Resources         Indicator           Barriers                        Frame

 Who is the     Who will           What is         How will you       What issues      Who else        How long
  primary        do it?           needed?          show it was        need to be      should be         will the
 audience?                                         completed?         addressed?      involved?      project take?



Illinois       Data and         Survey tool and   Survey tool        Return of      Health care      Ongoing
Asthma         Surveillance     development of    designed,          surveys from   professionals
Partnership    Work Group,      survey            implemented and    providers
               Education Work   methodology       report developed
               Group                              on findings




                                                      - 35 -
      Strategy 3. On an ongoing basis, with the Occupational Asthma Work Group collect
                     and analyze more detailed state-level information on occupational factors in
                     the development of asthma.

    Target      Responsible      Anticipated         Measurable          Anticipated       Collaborators          Time
  Population      Person          Resources           Indicator            Barriers                              Frame

  Who is the      Who will         What is          How will you         What issues           Who else        How long
   primary         do it?         needed?           show it was          need to be           should be         will the
  audience?                                         completed?           addressed?           involved?      project take?



Illinois        Data and       Data and            Report on           Identifying and     Businesses and    Ongoing
Asthma          Surveillance   information on      analysis of         accessing           industries
Partnership     Work Group,    occupational        occupational        information and
                Occupational   asthma, method      asthma              data sources
                Asthma Work    to study            information
                Group



      Strategy 4. Support existing studies and work to initiate new studies where needed that
                      would address disability from asthma, natural history of asthma and risk
                      factors for exacerbation.

    Target      Responsible      Anticipated         Measurable          Anticipated       Collaborators          Time
  Population      Person          Resources           Indicator            Barriers                              Frame

  Who is the      Who will         What is          How will you         What issues           Who else        How long
   primary         do it?         needed?           show it was          need to be           should be         will the
  audience?                                         completed?           addressed?           involved?      project take?



Illinois        Data and       Money, list of      New studies         Collection of       Local health      4 years
Asthma          Surveillance   current             initiated and       information from    departments,
Partnership     work group     studies             report developed    studies, assess-    community-
                                                   on findings from    ment of results     based agencies,
                                                   new and existing    and meta analy-     local asthma
                                                   studies             sis of study        consortia
                                                                       results


      Strategy 5. Incorporate state of Illinois data into national tracking systems.

   Target      Responsible      Anticipated         Measurable          Anticipated        Collaborators         Time
 Population      Person          Resources           Indicator            Barriers                              Frame

 Who is the      Who will          What is          How will you        What issues           Who else         How long
  primary         do it?          needed?           show it was         need to be           should be          will the
 audience?                                          completed?          addressed?           involved?       project take?



Illinois       Data and        Data,               Data                Collection of       Illinois Asthma   5 years
Asthma         Surveillance    information on      incorporated into   data, analysis of   Partnership,
Partnership    Work Group      national tracking   national health     data, and report-   organizations
                               systems             tracking systems,   ing of data         and agencies
                                                   such as Health      comprehensively     with data
                                                   Trak System                             sources


                                                        - 36 -
     5. Goal. Identify modifiable risk factors, particularly in the community
              and workplace, leading to a reduction in the incidence,
              morbidity and mortality associated with asthma in Illinois.
      Strategy 1. Solicit information on co-morbid conditions.

    Target       Responsible      Anticipated     Measurable         Anticipated         Collaborators           Time
  Population       Person          Resources       Indicator           Barriers                                 Frame

  Who is the       Who will         What is       How will you       What issues            Who else          How long
   primary          do it?         needed?        show it was        need to be            should be           will the
  audience?                                       completed?         addressed?            involved?        project take?



 Illinois        Data and       Linkages to     Information on      Identifying key     Work groups,         1 year
 Asthma          Surveillance   co-morbid       co-morbid           information         organizations
 Partnership     work group     projects        conditions          sources             and agencies
                                                obtained and                            that focus on co-
                                                developed into                          morbid
                                                reportable                              conditions
                                                format


      Strategy 2. Identify different risk factors for asthma in definable population subgroups.

    Target      Responsible       Anticipated    Measurable          Anticipated        Collaborators            Time
  Population      Person           Resources      Indicator            Barriers                                 Frame

  Who is the      Who will          What is      How will you        What issues           Who else           How long
   primary         do it?          needed?       show it was         need to be           should be            will the
  audience?                                      completed?          addressed?           involved?         project take?



Illinois        Data and        List of risk    Report on          Time, knowledge      Work groups         2 years
Asthma          Surveillance    factors and     findings on risk   gaps, availability
Partnership     work group      definition of   factors within     of research
                                population      population
                                subgroups,      subgroups
                                studies



      Strategy 3. Identify barriers to environmental modification that people with asthma may face.

   Target      Responsible       Anticipated     Measurable         Anticipated         Collaborators           Time
 Population      Person           Resources       Indicator           Barriers                                 Frame

 Who is the       Who will         What is       How will you       What issues            Who else           How long
  primary          do it?         needed?        show it was        need to be            should be            will the
 audience?                                       completed?         addressed?            involved?         project take?



Illinois        Data and        List of         Recommendations    Access to indus-     OA Work Group,      3 years
Asthma          Surveillance    environmental   for                tries, business      community-
Partnership     Work Group      risk factors,   environmental      and other groups     based agencies,
                                research        modifications      to determine bar-    local asthma
                                studies                            riers to identify    consortia,
                                                                   recommenda-          businesses and
                                                                   tions                business assoc.

                                                     - 37 -
     Strategy 4. Expand state agency involvement to address asthma-related risk factors.

   Target      Responsible     Anticipated         Measurable         Anticipated        Collaborators         Time
 Population      Person         Resources           Indicator           Barriers                              Frame

 Who is the      Who will        What is           How will you       What issues           Who else         How long
  primary         do it?        needed?            show it was        need to be           should be          will the
 audience?                                         completed?         addressed?           involved?       project take?



Illinois       Data and       Contact             Partnerships       None                Illinois          1 year
Asthma         Surveillance   person              established                            Asthma
Partnership    Work Group                         within state                           Partnership
and state                                         agencies
agencies




     6. Goal. Estimate the cost of asthma to the state in Illinois.
     Strategy 1. Review data on the cost effectiveness of a variety of interventions,
                    particularly chronic disease self-management strategies.

    Target     Responsible     Anticipated         Measurable          Anticipated       Collaborators          Time
  Population     Person         Resources           Indicator            Barriers                              Frame

  Who is the     Who will         What is          How will you        What issues          Who else         How long
   primary        do it?         needed?           show it was         need to be          should be          will the
  audience?                                        completed?          addressed?          involved?       project take?



Illinois       Data and       List of             Report on          Time,               Chronic           4 years
Asthma         Surveillance   interventions and   findings of cost   obtaining           disease
Partnership    Work Group     self-management     analysis           information         programs, work
                              strategies,                                                groups,
                              research designs                                           healthcare
                                                                                         professionals



      Strategy 2. Develop a strategy to assemble a comprehensive list of indirect and direct
                     costs of asthma and determine the total cost.


   Target      Responsible     Anticipated         Measurable         Anticipated        Collaborators         Time
 Population      Person         Resources           Indicator           Barriers                              Frame

 Who is the      Who will        What is           How will you       What issues           Who else         How long
  primary         do it?        needed?            show it was        need to be           should be          will the
 audience?                                         completed?         addressed?           involved?       project take?



Illinois       Data and       Time, access to     Strategy           Identification of   State agencies,   5 years
Asthma         Surveillance   databases,          developed          and access to       work groups,
Partnership    Work Group,    consensus on                           databases           community-
               Occupational   what constitutes                                           based agencies,
               Asthma Work    direct and                                                 local asthma
               Group          indirect costs                                             consortia


                                                       - 38 -
 Education

      1. Goal. Promote asthma training for health care professionals
               statewide who work with asthma patients.
     Strategy 1. Identify target population, especially primary care physicians (such as
                    pediatricians, family practice physicians, internists), emergency physicians,
                    nurse practitioners and physician assistants to receive asthma training.

    Target      Responsible        Anticipated         Measurable          Anticipated       Collaborators       Time
  Population      Person            Resources           Indicator            Barriers                           Frame

  Who is the      Who will           What is           How will you       What issues           Who else       How long
   primary         do it?           needed?            show it was        need to be           should be        will the
  audience?                                            completed?         addressed?           involved?     project take?



Health care     Education Work   Time                 List of health     Time, buy in from   Health care     3 months
professionals   Group                                 care profession-   health care         professional
                                                      als for training   professionals       organizations




      Strategy 2. Identify asthma experts who will provide training based on the NHLBI
                     guidelines.

   Target       Responsible       Anticipated          Measurable         Anticipated        Collaborators       Time
 Population       Person           Resources            Indicator           Barriers                            Frame

 Who is the      Who will            What is           How will you       What issues           Who else       How long
  primary         do it?            needed?            show it was        need to be           should be        will the
 audience?                                             completed?         addressed?           involved?     project take?



Health care     Education work   Time,                List of asthma     Time, money,        Health care     6 months
professionals   group            materials            experts            buy-in from         professional
and asthma                       (including NHLBI                        health care         organizations
experts                          guidelines),                            professionals
                                 linkages to target
                                 populations




                                                           - 39 -
     Strategy 3. Identify quality improvement experts to assist trainers in providing high
                     quality asthma training.

   Target       Responsible       Anticipated          Measurable          Anticipated       Collaborators           Time
 Population       Person           Resources            Indicator            Barriers                               Frame

 Who is the      Who will            What is           How will you        What issues          Who else           How long
  primary         do it?            needed?            show it was         need to be          should be            will the
 audience?                                             completed?          addressed?          involved?         project take?



Quality         Education Work   Linkages, time,      List of quality     Time, money,       Illinois            6 months
improvement     Group            training materials   improvement         linkages to        Asthma
experts                                               experts to assist   identify experts   Partnership
                                                      with training.




     Strategy 4. Provide asthma training for health care professionals (such as nurses, nurse
                       practitioners, respiratory therapists, physician assistants) who will serve as
                       asthma educators and improve the system of asthma care in their setting.

   Target       Responsible       Anticipated          Measurable          Anticipated       Collaborators           Time
 Population       Person           Resources            Indicator            Barriers                               Frame

 Who is the       Who will           What is           How will you        What issues          Who else           How long
  primary          do it?           needed?            show it was         need to be          should be            will the
 audience?                                             completed?          addressed?          involved?         project take?



Health care     Education Work   Time, meeting        Training            Recruitment of     Illinois Asthma     Ongoing
professionals   Group            space,               implemented,        health care        Partnership,
                                 materials            agenda from         professionals;     health care orga-
                                                      workshops and       logistics          nizations
                                                      meetings




                                                           - 40 -
      2. Goal. Disseminate the National Heart Lung and Blood Institute
               (NHLBI) guidelines across the state.
      Strategy 1. Promote NHLBI guidelines on the IDPH Web site.

    Target      Responsible       Anticipated         Measurable          Anticipated       Collaborators          Time
  Population      Person           Resources           Indicator            Barriers                              Frame

  Who is the      Who will          What is           How will you       What issues           Who else          How long
   primary         do it?          needed?            show it was        need to be           should be           will the
  audience?                                           completed?         addressed?           involved?        project take?



Health care     Education work   Time,               Guidelines         Time,               IAP, health care   1 year
professionals   group            computer            disseminated via   materials, ensur-   professional
                                 system, internet    web site. Notice   ing access to       organizations,
                                 access, materials   of web site sent   under-served        librarians and
                                 to make others      to target          (those with no      other who can
                                 aware of site       population         computers)          assist persons
                                                                                            w/o computers.


      Strategy 2. Disseminate NHLBI guidelines during workshops with target populations.

   Target       Responsible       Anticipated         Measurable         Anticipated        Collaborators          Time
 Population       Person           Resources           Indicator           Barriers                               Frame

 Who is the      Who will           What is           How will you       What issues           Who else          How long
  primary         do it?           needed?            show it was        need to be           should be           will the
 audience?                                            completed?         addressed?           involved?        project take?



Health care     Education Work   Time,               Guidelines         Time, travel,       Illinois           2 years
professionals   Group            materials,          disseminated and   recruiting          Asthma
                                 meeting spaces      workshops con-     participants,       Partnership
                                                     ducted, list of    printing Health
                                                     workshops and      care organiza-
                                                     number of          tions,
                                                     attendees




                                                          - 41 -
       3. Goal.        Facilitate provision of asthma education statewide for
                       asthma patients and care givers of people with asthma.
      Strategy 1. Identify and promote effective asthma self-management programs, which
                        are based on the NHLBI guidelines, with emphasis on high-risk populations.

    Target         Responsible        Anticipated           Measurable          Anticipated       Collaborators           Time
  Population         Person            Resources             Indicator            Barriers                               Frame

  Who is the         Who will           What is            How will you         What issues          Who else           How long
   primary            do it?           needed?             show it was          need to be          should be            will the
  audience?                                                completed?           addressed?          involved?         project take?



High-risk          Education Work   Effective             List of             Time, identifying   LHDs, community-    6 months
populations with   Group            self-management       identified          programs,           based agencies,
asthma                              programs, time,       programs, list of   access to high      local asthma con-
                                    meeting space,        workshops, and      risk populations,   sortia community
                                    recruitment           number and          adherence           gate keepers
                                                          demographics of
                                    mechanism
                                                          attendees


      Strategy 2. Develop and promote effective education for caregivers of people with
                        asthma, including identification and management of asthma emergencies.

   Target          Responsible       Anticipated           Measurable          Anticipated        Collaborators           Time
 Population          Person           Resources             Indicator            Barriers                                Frame

 Who is the         Who will            What is            How will you        What issues           Who else           How long
  primary            do it?            needed?             show it was         need to be           should be            will the
 audience?                                                 completed?          addressed?           involved?         project take?



Caregivers of      Education work   Educational           List of             Time, access to     LHDs,               6 months
people with        group            programs,             workshops and       care givers, col-   community-
asthma (parents,                    collaboration from    number of atten-    laboration from     based agencies,
family members,                     health care profes-   dees                health care         local asthma con-
day care                            sionals, recruit-                         professionals       sortia, community
specialists)                        ment mechanism                                                gatekeepers




                                                               - 42 -
     Strategy 3. Provide asthma training for health care professionals (such as nurses, nurse
                     practitioners, respiratory therapists, physician assistants) who will serve as
                     asthma educators.

    Target       Responsible        Anticipated       Measurable       Anticipated      Collaborators           Time
  Population       Person            Resources         Indicator         Barriers                              Frame

  Who is the       Who will           What is         How will you     What issues         Who else           How long
   primary          do it?           needed?          show it was      need to be         should be            will the
  audience?                                           completed?       addressed?         involved?         project take?



Health care      Education Work   Time, meeting      Training        Recruitment of     Illinois Asthma     Ongoing
professionals    Group            space, materials   implemented,    health care        Partnership,
                                                     agenda from     professionals;     health care orga-
                                                     workshops and   logistics          nizations
                                                     meetings




     Strategy 4. Provide asthma training for community health workers and peer educators
                      who will serve as asthma educators.

   Target        Responsible       Anticipated        Measurable      Anticipated       Collaborators           Time
 Population        Person           Resources          Indicator        Barriers                               Frame

 Who is the       Who will           What is          How will you    What issues          Who else           How long
  primary          do it?           needed?           show it was     need to be          should be            will the
 audience?                                            completed?      addressed?          involved?         project take?



Community        Education Work   Time, meeting      Training        Recruitment of     Illinois Asthma     Ongoing
health workers   Group            space, materials   implemented,    community          Partnership,
and peer                                             agenda from     members to train   community orga-
educators                                            workshops and                      nizations
                                                     meetings




                                                         - 43 -
     4. Goal. Promote asthma awareness, education and screening programs
              in communities across the state.
     Strategy 1. Identify effective asthma outreach strategies for communities and identify
                       local asthma experts who will provide education and/or screening.

   Target         Responsible       Anticipated         Measurable         Anticipated      Collaborators           Time
 Population         Person           Resources           Indicator           Barriers                              Frame

 Who is the        Who will           What is           How will you       What issues         Who else           How long
  primary           do it?           needed?            show it was        need to be         should be            will the
 audience?                                              completed?         addressed?         involved?         project take?



Target            Education Work   Time, collabora-    List of key        Time, access to   Illinois Asthma     1 year
communities and   Group            tion with asthma    outreach and       asthma experts,   Partnership,
asthma experts                     experts, collabo-   community          access to         LHDs, communi-
                                   ration with         strategies, list   marketing         ty- based agen-
                                   marketing           of local asthma    experts           cies, local asth-
                                   experts
                                                       experts                              ma consortia



     Strategy 2. Identify effective asthma educational materials and resources that promote
                        the NHLBI guidelines, including materials geared toward low literacy,
                        multiple languages and cultural competence.

    Target        Responsible        Anticipated         Measurable         Anticipated     Collaborators            Time
  Population        Person            Resources           Indicator           Barriers                              Frame

  Who is the        Who will           What is           How will you       What issues         Who else          How long
   primary           do it?           needed?            show it was        need to be         should be           will the
  audience?                                              completed?         addressed?         involved?        project take?



General           Education Work   Time, access to     List of            Developing        Illinois Asthma     1 year
public and        Group            databases           materials          criteria for      Partnership,
people with                                                               effective         organizations
asthma                                                                    asthma            and agencies
                                                                          educational       with translation
                                                                          materials         capabilities




                                                             - 44 -
      Strategy 3. Establish a clearinghouse for asthma information based on the NHLBI
                         guidelines.

   Target          Responsible       Anticipated          Measurable      Anticipated          Collaborators           Time
 Population          Person           Resources            Indicator        Barriers                                  Frame

 Who is the         Who will            What is           How will you    What issues             Who else           How long
  primary            do it?            needed?            show it was     need to be             should be            will the
 audience?                                                completed?      addressed?             involved?         project take?



People with        Education Work   Time and loca-       Clearinghouse   Time,                 Illinois Asthma     3 years
asthma and their   Group            tion for clearing-   established     maintenance of        Partnership,
caregivers,                         house, materials,                    clearinghouse,        LHDs, communi-
school                              collaboration                        logistics of clear-   ty- based agen-
personnel,                          with the                             inghouse (e.g.,       cies, local asth-
general public                      American Lung                        virtual web-based     ma consortia
                                    Association                          clearinghouse)




 Occupational Asthma
      1. Goal.        Increase awareness of asthma, including its impact, the
                      importance of early diagnosis and appropriate management,
                      and the availability of effective treatment and prevention
                      strategies, in working adults in Illinois.
      Strategy 1. Develop a solid knowledge base on prevention of asthma in the workplace
                        that can be shared with health care professionals working in industry.

    Target         Responsible        Anticipated         Measurable       Anticipated         Collaborators            Time
  Population         Person            Resources           Indicator         Barriers                                  Frame

  Who is the         Who will           What is           How will you     What issues             Who else          How long
   primary            do it?           needed?            show it was      need to be             should be           will the
  audience?                                               completed?       addressed?             involved?        project take?



Health care        Occupational     Time, access to      Finished        Acceptance of         Representatives     6 months
professionals      Asthma Work      scientific           document        material by           from
                   Group            databases,                           businesses            businesses
                                    word
                                    processing
                                    mechanism




                                                             - 45 -
      Strategy 2. Develop a solid knowledge base on asthma in the workplace that can be
                        shared with primary care providers to allow them to more effectively
                        educate patients who work in high-risk industries.

   Target        Responsible         Anticipated      Measurable      Anticipated       Collaborators          Time
 Population        Person             Resources        Indicator        Barriers                              Frame

 Who is the        Who will            What is        How will you    What issues          Who else          How long
  primary           do it?            needed?         show it was     need to be          should be           will the
 audience?                                            completed?      addressed?          involved?        project take?



Primary care     Occupational       Time/access to   Finished        Acceptance by      Primary care       6 months
providers        Asthma and         scientific       document        primary care       providers on
                 Education Work     databases,                       providers and      committee, local
                 Groups             word                             dissemination to   asthma consortia
                                    processing                       providers
                                    mechanism



     Strategy 3. Work within Illinois communities to help identify and target those
                       business/industrial environments that have high asthma prevalence rates.

   Target        Responsible         Anticipated      Measurable      Anticipated       Collaborators          Time
 Population        Person             Resources        Indicator        Barriers                              Frame

 Who is the        Who will            What is        How will you    What issues          Who else          How long
  primary           do it?            needed?         show it was     need to be          should be           will the
 audience?                                            completed?      addressed?          involved?        project take?



Businesses and   Occupational       Time/access to   Finished        Time               Business           5 months
administration   Asthma and Data    scientific       document                           representatives
                 and Surveillance   databases,                                          and other state
                 Work Groups        word                                                agencies
                                    processing
                                    mechanism




                                                         - 46 -
     Strategy 4. Identify "best practices" locally, statewide and nationally that prevent the
                      development of asthma or workplace exacerbations of asthma.

   Target       Responsible     Anticipated         Measurable         Anticipated     Collaborators         Time
 Population       Person         Resources           Indicator           Barriers                           Frame

 Who is the      Who will         What is           How will you       What issues        Who else         How long
  primary         do it?         needed?            show it was        need to be        should be          will the
 audience?                                          completed?         addressed?        involved?       project take?



Employees and   Occupational   Access to health    Report contain-    None             Business          9 months
employers       Asthma Work    databases, evalu-   ing one page                        representatives
                Group          ation of program    descriptions of
                               materials related   "best practices"
                               to benchmarked
                               programs



     2. Goal. Identify effective methods of accommodation in the workplace
               for persons with asthma and similar methods of accommoda-
               tion and change to help prevent employees from developing
               asthma through a benchmarking process.
     Strategy 1. Develop consistent asthma messages that are designed to reach specific
                     employee populations, particularly those designated as underserved.

   Target       Responsible     Anticipated         Measurable         Anticipated     Collaborators         Time
 Population       Person         Resources           Indicator           Barriers                           Frame

 Who is the       Who will         What is          How will you       What issues        Who else         How long
  primary          do it?         needed?           show it was        need to be        should be          will the
 audience?                                          completed?         addressed?        involved?       project take?



Employees       Occupational   Time/access to      Finished           Getting          Employee          4 months
                Asthma Work    scientific          document,          information to   representatives
                Group          databases, word     number of          employees
                               processing          employees
                               mechanism           reached




                                                        - 47 -
     Strategy 2. Become a clearinghouse for the latest public information on occupational asthma.

    Target     Responsible     Anticipated       Measurable      Anticipated   Collaborators          Time
  Population     Person         Resources         Indicator        Barriers                          Frame

 Who is the      Who will         What is        How will you    What issues      Who else          How long
  primary         do it?         needed?         show it was     need to be      should be           will the
 audience?                                       completed?      addressed?      involved?        project take?



Employees      Occupational   Time/access to    Finished        Obtaining      Employee           Ongoing
               Asthma Work    scientific        document,       information    representatives
               Group          databases,        dissemination
                              word processing   of records
                              mechanism,
                              access to
                              Internet


     Strategy 3. Work with insurers to develop programs that will help make employee-
                     based health care systems more responsive and better able to meet the
                     needs of working people with asthma.

   Target      Responsible     Anticipated       Measurable      Anticipated   Collaborators          Time
 Population      Person         Resources         Indicator        Barriers                          Frame

 Who is the     Who will         What is         How will you    What issues      Who else          How long
  primary        do it?         needed?          show it was     need to be      should be           will the
 audience?                                       completed?      addressed?      involved?        project take?



Insurance      Occupational   Meetings times    Program         Resistance     Insurance          5 years
personnel      Asthma Work    and places        manual                         representatives,
               Group                                                           human resources
                                                                               representatives




                                                    - 48 -
      3. Goal. Increase awareness among administration, management and
               human resource personnel in businesses throughout Illinois
               on occupational asthma, including risk factors, impact,
               prevention strategies and management.
      Strategy 1. Develop a list of Illinois industries that have high asthma prevalence rates
                     and distribute to local health departments to allow staff to identify businesses
                     in their areas that can be targeted for health education messages related to
                     asthma in the workplace.

   Target        Responsible     Anticipated          Measurable      Anticipated    Collaborators          Time
 Population        Person         Resources            Indicator        Barriers                           Frame

 Who is the       Who will          What is           How will you    What issues       Who else          How long
  primary          do it?          needed?            show it was     need to be       should be           will the
 audience?                                            completed?      addressed?       involved?        project take?



Local health     Occupational   Materials, list of   Finished        None            Enforcement        7 months
departments      Asthma Work    industries           document        anticipated     personnel, local
                 Group                                                               health depart-
                                                                                     ment personnel




      Strategy 2. Coordinate with the IDPH’s Division of Environmental Health to
                       educate businesses regarding integrated pest management (IPM) and other
                       techniques that reduce worker exposure to potential risk factors.

    Target       Responsible      Anticipated         Measurable       Anticipated   Collaborators          Time
  Population       Person          Resources           Indicator         Barriers                          Frame

  Who is the       Who will         What is           How will you     What issues      Who else          How long
   primary          do it?         needed?            show it was      need to be      should be           will the
  audience?                                           completed?       addressed?      involved?        project take?



Businesses/      Occupational   Materials,           Finished        Acceptance of   Business           9 months
administrators   Asthma Work    time/access to       document        materials       representatives,
                 Group          scientific                                           chemists
                                databases,
                                word
                                processing
                                mechanism




                                                         - 49 -
      4. Goal.         Coordinate services or recommend services related to
                       monitoring and improving the workplace environment.
     Strategy 1. Develop and market an occupational tool kit that includes a list of resources
                        businesses may contact to undertake workplace environment monitoring.

   Target         Responsible        Anticipated        Measurable      Anticipated   Collaborators       Time
 Population         Person            Resources          Indicator        Barriers                       Frame

 Who is the         Who will            What is         How will you    What issues      Who else       How long
  primary            do it?            needed?          show it was     need to be      should be        will the
 audience?                                              completed?      addressed?      involved?     project take?



Local health      Occupational      Materials,         Finished        Distribution   Businesses      6 months
departments and   Asthma work       time/access to     document
businesses        group,            scientific data-
                  relevant state    bases, word
                  agencies          processing
                                    mechanism



     Strategy 2. Work with state and federal enforcement agencies to develop a list of
                         businesses with issues related to environmental quality and distribute
                         educational material to those businesses.

   Target         Responsible        Anticipated        Measurable      Anticipated   Collaborators       Time
 Population         Person            Resources          Indicator        Barriers                       Frame

 Who is the         Who will            What is         How will you    What issues      Who else       How long
  primary            do it?            needed?          show it was     need to be      should be        will the
 audience?                                              completed?      addressed?      involved?     project take?



State and         Occupational      Materials,         Finished        Access to      Government      3 months
federal           Asthma Work       time/access to     document        information    agencies
enforcement       Group, relevant   scientific
agencies          government        databases,
                  agencies          word processing
                                    mechanism




                                                           - 50 -
     Strategy 3. Develop a mechanism to provide public recognition to businesses that
                     improve the workplace environment.

    Target      Responsible         Anticipated       Measurable         Anticipated   Collaborators       Time
  Population      Person             Resources         Indicator           Barriers                       Frame

  Who is the      Who will            What is         How will you       What issues      Who else       How long
   primary         do it?            needed?          show it was        need to be      should be        will the
  audience?                                           completed?         addressed?      involved?     project take?



Businesses,     Occupational      Materials and      Model plaque      None            Government      1 year
state and       Asthma Work       plaques, meeting   and agenda for    anticipated     agencies
federal         Group, relevant   times and places   awards ceremony
enforcement     government
agencies        agencies




     5. Goal.      Work with the Illinois Asthma Partnership to advocate for the
                   development of adequate programs for health care insurance
                   coverage, disability insurance coverage and retraining for
                   workers affected by occupational asthma.

    Strategy 1. Provide information to human resource personnel to accommodate persons
                      who may need job retraining to avoid exposure to occupational asthma risk
                      factors.


   Target      Responsible         Anticipated        Measurable        Anticipated    Collaborators       Time
 Population      Person             Resources          Indicator          Barriers                        Frame

 Who is the      Who will            What is          How will you      What issues       Who else       How long
  primary         do it?            needed?           show it was       need to be       should be        will the
 audience?                                            completed?        addressed?       involved?     project take?



Businesses     Occupational       Materials,         Finished          Resistance      Business        7 months
(human         Asthma Work        time/access to     document                          personnel
resources)     Group,             scientific data-                                     (human
               relevant state     bases, word pro-                                     resources)
               agencies           cessing mecha-
                                  nism, meeting
                                  times and places




                                                         - 51 -
      Strategy 2. Identify current health care and disability insurance programs for
                         occupational asthma in Illinois.

    Target        Responsible        Anticipated        Measurable       Anticipated   Collaborators       Time
  Population        Person            Resources          Indicator         Barriers                       Frame

 Who is the         Who will            What is         How will you     What issues      Who else       How long
  primary            do it?            needed?          show it was      need to be      should be        will the
 audience?                                              completed?       addressed?      involved?     project take?



Insurers          Occupational      Materials,         Write paper on   Access to      Insurance       1 year
                  Asthma Work       time/access to     issues           information    personnel,
                  Group, relevant   scientific data-                                   Illinois
                  state agencies    bases                                              Department of
                                                                                       Public Aid




           Strategy 3. Partner with federal and state enforcement agencies to develop
                            programs that protect workers and make the workplace environment
                            safe.

   Target         Responsible        Anticipated        Measurable       Anticipated   Collaborators       Time
 Population         Person            Resources          Indicator         Barriers                       Frame

 Who is the         Who will            What is         How will you     What issues     Who else        How long
  primary            do it?            needed?          show it was      need to be     should be         will the
 audience?                                              completed?       addressed?     involved?      project take?



State and         Occupational      Materials,         Agenda from      Resistance     Government      5 years
federal           Asthma Work       meeting times      meetings,                       agencies,
enforcement       Group, relevant   and places         program plan                    businesses
agencies,         government
businesses        agencies




                                                            - 52 -
Schools

     1. Goal.       Encourage all schools to obtain an appropriate written action
                    plan for every child with asthma.
     Strategy 1. Work with appropriate organizations and the Education Work Group to
                      develop effective educational programs regarding asthma action/
                      management plans based on the National Heart, Lung and Blood Institute
                      (NHLBI) guidelines.

    Target       Responsible         Anticipated       Measurable         Anticipated       Collaborators            Time
  Population       Person             Resources         Indicator           Barriers                                Frame

  Who is the       Who will             What is       How will you        What issues          Who else           How long
   primary          do it?             needed?        show it was         need to be          should be            will the
  audience?                                           completed?          addressed?          involved?         project take?



Health care      School Work        Guidelines,      Illinois Asthma    Buy-in from         IAP, health care    3 years
professionals,   Group, Education   educational      Partnership with   health care         organizations,
care-givers,     Work Group         programs,        health care        professionals       health care
school                              materials, and   societies                              societies such as
personnel                           meeting times    established.,                          the American
                                    and places       distribution of                        Academy of
                                                     the guidelines                         Pediatrics


     Strategy 2. Encourage school districts to establish a team of school personnel to ensure
                      an appropriate written action plan for each child with asthma

   Target        Responsible         Anticipated      Measurable         Anticipated        Collaborators           Time
 Population        Person             Resources        Indicator           Barriers                                Frame

 Who is the       Who will             What is        How will you       What issues           Who else           How long
  primary          do it?             needed?         show it was        need to be           should be            will the
 audience?                                            completed?         addressed?           involved?         project take?



School           School Work        Asthma action    School             Materials, buy-in   Schools             1 year
personnel        Group              plans            personnel          from school
                                                     identified from    personnel
                                                     each school




                                                          - 53 -
      2. Goal. Support appropriate continuing education in asthma
               management for school personnel.
      Strategy 1. Encourage providers of continuing education programs for teachers,
                          education administrators and school nurses to include asthma as part of the
                          curriculum.

   Target           Responsible     Anticipated    Measurable         Anticipated        Collaborators          Time
 Population           Person         Resources      Indicator           Barriers                               Frame

 Who is the          Who will         What is      How will you       What issues           Who else          How long
  primary             do it?         needed?       show it was        need to be           should be           will the
 audience?                                         completed?         addressed?           involved?        project take?



Teachers, school    School Work    Educational    Continuing         Access to           Schools and        Ongoing
nurses and          Group          programs and   education units    teachers and        continuing
education                          materials      (CEUs) given       administrators,     education groups
administrators                                                       money for
                                                                     CEUs, integration
                                                                     with existing
                                                                     programs


      Strategy 2. Encourage teacher and education administration students to take a course in
                         health and safety as part of their college training.

    Target          Responsible     Anticipated    Measurable         Anticipated        Collaborators          Time
  Population          Person         Resources      Indicator           Barriers                               Frame

 Who is the           Who will        What is      How will you       What issues           Who else          How long
  primary              do it?        needed?       show it was        need to be           should be           will the
 audience?                                         completed?         addressed?           involved?        project take?



College             School Work    Time,          Curriculum taken   Colleges offering   Colleges,          5 years
students enrolled   Group          curriculums    by students        curriculum, time    accrediting
in teacher and                                                       for students to     bodies of
education admin-                                                     take additional     colleges
istrator degrees                                                     classes




                                                       - 54 -
      Strategy 3. Promote continuing asthma education for all school nurses (day care through college).

    Target          Responsible     Anticipated       Measurable        Anticipated         Collaborators           Time
  Population          Person         Resources         Indicator          Barriers                                 Frame

  Who is the          Who will        What is         How will you      What issues            Who else          How long
   primary             do it?        needed?          show it was       need to be            should be           will the
  audience?                                           completed?        addressed?            involved?        project take?



School nurses,      School Work    Educational      Education         Materials, time,     Illinois School     Ongoing
university health   Group          programs         programs          school nurse         Nurses
services                                            implemented       buy-in               Association,
                                                                                           Illinois Board of
                                                                                           Higher Education




      Strategy 4. Continue to provide an annual satellite conference for administrators,
                         personnel, children and families on issues related to asthma in the schools.

    Target          Responsible    Anticipated       Measurable        Anticipated         Collaborators           Time
  Population          Person        Resources         Indicator          Barriers                                 Frame

 Who is the          Who will         What is        How will you      What issues            Who else           How long
  primary             do it?         needed?         show it was       need to be            should be            will the
 audience?                                           completed?        addressed?            involved?         project take?



School              School Work   Speakers,         Satellite         Obtaining            IDPH training       Annually
administrators,     Group         funding,          conference held   speakers,            center
personnel, chil-                  materials,                          funding, logistics
dren and families                 printing




      Strategy 5. Implement evidence based programs related to asthma for school staff.

    Target          Responsible    Anticipated       Measurable        Anticipated         Collaborators           Time
  Population          Person        Resources         Indicator          Barriers                                 Frame

 Who is the          Who will         What is        How will you      What issues            Who else           How long
  primary             do it?         needed?         show it was       need to be            should be            will the
 audience?                                           completed?        addressed?            involved?         project take?



Schools             School Work   Model programs,   Model programs    Access to            American Lung       Ongoing
                    Group         such as the       provided          schools, funding     Association,
                                  ALA's                                                    school,
                                  "Asthma 101"                                             healthcare
                                                                                           professionals




                                                         - 55 -
      3. Goal. Support the development of indoor air quality and
               environmental improvements in schools.
      Strategy 1. Identify effective indoor air quality assessment methods.

   Target          Responsible    Anticipated          Measurable          Anticipated       Collaborators          Time
 Population          Person        Resources            Indicator            Barriers                              Frame

 Who is the          Who will        What is           How will you       What issues           Who else          How long
  primary             do it?        needed?            show it was        need to be           should be           will the
 audience?                                             completed?         addressed?           involved?        project take?



Schools            School Work   Access to            Assessment tool    Time and buy-in     Occupational       1 year
                   Group         scientific           identified or      from the schools    Asthma Work
                                 literature to        developed for                          Group, school
                                 benchmark            implementation                         administration
                                 effective
                                 assessment tools



      Strategy 2. Provide information about indoor air quality to schools.

    Target         Responsible    Anticipated          Measurable          Anticipated       Collaborators          Time
  Population         Person        Resources            Indicator            Barriers                              Frame

 Who is the          Who will        What is           How will you        What issues          Who else          How long
  primary             do it?        needed?            show it was         need to be          should be           will the
 audience?                                             completed?          addressed?          involved?        project take?



School districts   School Work   Assessment           List of            Interest from       Occupational       2 years
and school         Group         tools, checklists,   partnerships       target popula-      Asthma Work
boards                           educational          developed,         tions and buy-in    Group, schools
                                 information          education                              and engineers,
                                                      provided, and                          architecture and
                                                      assessment tools                       construction
                                                      provided                               companies


      Strategy 3. Work with school districts to identify potential funding sources to implement
                       indoor air quality and environmental improvements.

   Target          Responsible    Anticipated          Measurable         Anticipated        Collaborators          Time
 Population          Person        Resources            Indicator           Barriers                               Frame

 Who is the         Who will        What is            How will you       What issues           Who else          How long
  primary            do it?        needed?             show it was        need to be           should be           will the
 audience?                                             completed?         addressed?           involved?        project take?



Schools            School Work   Linkages to          Funding obtained   Time, identifying   Illinois Asthma    3 years
                   Group         funding sources                         funding sources     Partnership,
                                                                                             ISBE, IEPA




                                                           - 56 -
      4. Goal.        Encourage schools to comply with the state's asthma
                      medication law (Public Act 92-0402).
     Strategy 1. Provide information about the asthma medication law (Public Act 92-0402) to
                       all school personnel.

   Target          Responsible     Anticipated    Measurable         Anticipated       Collaborators          Time
 Population          Person         Resources      Indicator           Barriers                              Frame

 Who is the         Who will         What is      How will you       What issues          Who else          How long
  primary            do it?         needed?       show it was        need to be          should be           will the
 audience?                                        completed?         addressed?          involved?        project take?



School personnel   School Work    Educational    School personnel   Time, money for    Schools,           Ongoing
                   Group          programs,      educated on        programming,       community-
                                  materials      asthma and on      accessibility to   based agencies,
                                                 the asthma         school personnel   local asthma
                                                 medication law                        consortia, local
                                                 (P.A. 92-042)                         health
                                                                                       departments


     Strategy 2. Provide information about the asthma medication law (Public Act 92-0402) to
                        the Illinois School Nurses Association, school personnel organizations and
                        associations (including teachers, secretaries, and bus drivers), parents and
                        guardians, college educators, and day care providers.

    Target         Responsible     Anticipated    Measurable         Anticipated       Collaborators          Time
  Population         Person         Resources      Indicator           Barriers                              Frame

 Who is the          Who will         What is     How will you       What issues          Who else          How long
  primary             do it?         needed?      show it was        need to be          should be           will the
 audience?                                        completed?         addressed?          involved?        project take?



ISNA, teachers     School Work    Materials      Education          Access to target   Schools, local     2 years
union secre-       Group                         provided to        populations,       health depart-
taries, bus dri-                                 target             funding for        ments, communi-
vers, secondary                                  populations        materials          ty- based
educators, day                                                                         agencies, local
car providers,                                                                         asthma consortia
security, etc.




                                                     - 57 -
     5. Goal.         Advocate for asthma education certification for school nurses,
                      coaches and physical education teachers.

     Strategy 1. Identify appropriate certification programs.

     Target        Responsible         Anticipated         Measurable       Anticipated          Collaborators            Time
   Population        Person             Resources           Indicator         Barriers                                   Frame

   Who is the        Who will             What is         How will you      What issues             Who else           How long
    primary           do it?             needed?          show it was       need to be             should be            will the
   audience?                                              completed?        addressed?             involved?         project take?



 School nurses,    School work        Access to          Certification    Identifying and       ISBE, IAP,           1 year
 coaches and       group, steering    funding sources    program          justifying funding    schools, commu-
 physical          committee                             identified                             nity-based agen-
 education                                                                                      cies, local asth-
 teachers                                                                                       ma consortia,
                                                                                                LHDs



     Strategy 2. Develop a plan of action to implement certification programs.

   Target         Responsible         Anticipated        Measurable       Anticipated          Collaborators            Time
 Population         Person             Resources          Indicator         Barriers                                   Frame

 Who is the         Who will            What is          How will you     What issues             Who else            How long
  primary            do it?            needed?           show it was      need to be             should be             will the
 audience?                                               completed?       addressed?             involved?          project take?



School nurses     School Work        Language and       Plan of action   Resistance to         Illinois School      2 years
                  Group, steering    support for        developed        certification         Nurses
                  committee          certification                                             Association,
                                                                                               Partnership




                                                             - 58 -
      Strategy 3. Mandate asthma education certification for school nurses, coaches, and
                       physical education teachers.

    Target        Responsible        Anticipated     Measurable          Anticipated     Collaborators           Time
  Population        Person            Resources       Indicator            Barriers                             Frame

  Who is the        Who will            What is      How will you       What issues         Who else          How long
   primary           do it?            needed?       show it was        need to be         should be           will the
  audience?                                          completed?         addressed?         involved?        project take?



School nurses,    School Work       Support for     Mandate in place   Resistance to     ISNA,              5 years
coaches and       Group, steering   certification                      certification     Partnership,
physical educa-   committee                                                              Department of
tion teachers                                                                            Regulations,
                                                                                         ISBE, Teachers
                                                                                         Union



      6. Goal.       Improve access to asthma educational materials and asthma
                     medications and supplies for schools.
      Strategy 1. Encourage schools to ensure that teachers, parents and students have
                        access to education on asthma.

   Target         Responsible        Anticipated     Measurable         Anticipated      Collaborators          Time
 Population         Person            Resources       Indicator           Barriers                             Frame

 Who is the        Who will            What is       How will you       What issues         Who else          How long
  primary           do it?            needed?        show it was        need to be         should be           will the
 audience?                                           completed?         addressed?         involved?        project take?



School            School Work       Educational     Educational        Resistance from   Schools, ISBE,     5 years
administrators    Group             materials and   materials and      schools           LHDs, community-
                                    programs        programs avail-                      based agencies,
                                                    able to all                          local asthma
                                                    schools                              consortiums




                                                         - 59 -
     Strategy 2. Provide asthma information and resources to schools, day care workers and
                         colleges through collaboration with the Illinois State Board of Education, the
                         Illinois Department of Human Services and school networks.

   Target          Responsible     Anticipated     Measurable          Anticipated    Collaborators             Time
 Population          Person         Resources       Indicator            Barriers                              Frame

 Who is the         Who will          What is      How will you        What issues       Who else             How long
  primary            do it?          needed?       show it was         need to be       should be              will the
 audience?                                         completed?          addressed?       involved?           project take?



Schools            School Work    Materials       Materials           Funding for     Illinois State        1 year
                   Group                          provided to         materials       Board of
                                                  target population                   Education, Illinois
                                                                                      Department of
                                                                                      Human Services,
                                                                                      schools, colleges,
                                                                                      daycare facilities



     Strategy 3. Enhance knowledge of school personnel on proper use asthma
                        equipment (peak flow meters, nebulizers, spacers).

   Target          Responsible     Anticipated     Measurable          Anticipated    Collaborators             Time
 Population          Person         Resources       Indicator            Barriers                              Frame

 Who is the          Who will         What is      How will you        What issues       Who else             How long
  primary             do it?         needed?       show it was         need to be       should be              will the
 audience?                                         completed?          addressed?       involved?           project take?



School personnel   School Work    Equipment and   Education           Lack of         Local health          4 years
                   Group          educational     provided, school    equipment and   departments
                                  materials       personnel           desire to use
                                                  competent in        equipment
                                                  using equipment




                                                       - 60 -
      Strategy 4. Work to identify funding sources for schools to obtain asthma medications and
                    supplies to schools.

    Target     Responsible        Anticipated        Measurable         Anticipated      Collaborators          Time
  Population     Person            Resources          Indicator           Barriers                             Frame

 Who is the      Who will            What is         How will you       What issues         Who else          How long
  primary         do it?            needed?          show it was        need to be         should be           will the
 audience?                                           completed?         addressed?         involved?        project take?



Schools        School Work       Materials,         Education          Money, cost of    Schools, funding   4 years
               Group             funding for        provided,          medications and   sources
                                 equipment          equipment in       supplies
                                                    every school




      Strategy 5. Advocate for health care insurance coverage for school-based asthma
                     medications and supplies (inhaler, spacer, nebulizer, peak flow meter,
                     and asthma education).

    Target     Responsible        Anticipated        Measurable         Anticipated      Collaborators          Time
  Population     Person            Resources          Indicator           Barriers                             Frame

 Who is the      Who will            What is         How will you       What issues         Who else          How long
  primary         do it?            needed?          show it was        need to be         should be           will the
 audience?                                           completed?         addressed?         involved?        project take?



Legislators,   School Work       Time,              Cost benefit,      Access and buy-   Schools,           5 years
insurance      Group, steering   documentation of   educational        in to target      Education Work
companies      committee         effectiveness/     program on ben-    population        Group
                                 cost benefit for   efit, and lan-
                                 reimbursement      guage for change
                                                    completed




                                                         - 61 -
 State Coordination
      1. Goal.      Expand Illinois Asthma Partnership to include organizations/
                    agencies not currently involved but which serve the same or
                    similar target populations, address asthma or have the
                    potential to address asthma.

     Strategy 1. Identify target audiences for work group projects.

   Target       Responsible        Anticipated          Measurable         Anticipated       Collaborators         Time
 Population       Person            Resources            Indicator           Barriers                             Frame

 Who is the       Who will            What is           How will you       What issues          Who else         How long
  primary          do it?            needed?            show it was        need to be          should be          will the
 audience?                                              completed?         addressed?          involved?       project take?



Work groups,    Steering          Input from           Target groups      No interest from   LHDs,             1 year
high-risk       Committee and     partnership and      identified,        targeted groups,   community-
populations     Illinois Asthma   work groups,         projects           lack of aware-     based agencies,
                Partnership       time, recruitment,   identified         ness of asthma     local asthma
                                  materials, meet-                        initiative         consortia
                                  ing time and
                                  space


     Strategy 2. Identify organizations and agencies that work with target populations or
                      address asthma (such as inner city clinics, asthma clinics, youth
                      foundations).

    Target      Responsible         Anticipated         Measurable          Anticipated      Collaborators          Time
  Population      Person             Resources           Indicator            Barriers                             Frame

 Who is the       Who will            What is           How will you       What issues          Who else         How long
  primary          do it?            needed?            show it was        need to be          should be          will the
 audience?                                              completed?         addressed?          involved?       project take?



Key             Steering          Input from IAP       Increase in        No interest from   Local health      6 months
organizations   committee and     and work groups      membership         targeted groups,   departments,
and agencies    work groups       on recruitment       compared to        lack of aware-     community
that are not                      strategy and         quarterly report   ness of asthma     organizations
currently                         materials, meet-     of membership      initiative         and agencies,
involved                          ing time and         logs                                  local asthma
                                  space                                                      consortia




                                                            - 62 -
      Strategy 3. Identify organizations and agencies with linkages to target populations that
                        do not focus on asthma (for example, tobacco cessation programs).

    Target         Responsible       Anticipated          Measurable          Anticipated         Collaborators         Time
  Population         Person           Resources            Indicator            Barriers                               Frame

  Who is the         Who will          What is           How will you         What issues            Who else         How long
   primary            do it?          needed?            show it was          need to be            should be          will the
  audience?                                              completed?           addressed?            involved?       project take?



Organizations      Steering        Identify linkages,   Identified           No interest from     Work group        6 months
that have the      committee and   recruitment          organizations        org.’s; linking      members, LHDs,
potential to       work groups     materials and        identified in a      priorities to        community-
address asthma                     strategies, meet-    report               justify resources    based agencies,
through existing                   ing times and                             on joint projects;   local asthma
program areas                      spaces                                    lack of              consortia
                                                                             awareness


      2. Goal.         Implement and evaluate a pilot project for chronic disease
                       management based on a comprehensive case management
                       approach that relies on public health nursing.

      Strategy 1. Define Case Management.

   Target          Responsible      Anticipated          Measurable           Anticipated         Collaborators         Time
 Population          Person          Resources            Indicator             Barriers                               Frame

 Who is the         Who will          What is            How will you         What issues            Who else         How long
  primary            do it?          needed?             show it was          need to be            should be          will the
 audience?                                               completed?           addressed?            involved?       project take?



Steering           Steering        Definitions of       Agreed upon          None                 Education and     6 months
committee          committee       case manage-         definition of case                        Data and
                                   ment, access to      management,                               Surveillance
                                   health care          methods and                               Work Groups
                                   literature.          analysis.




                                                              - 63 -
      Strategy 2. Identify existing case management programs and develop linkages.

    Target         Responsible       Anticipated         Measurable        Anticipated        Collaborators       Time
  Population         Person           Resources           Indicator          Barriers                            Frame

 Who is the         Who will            What is          How will you      What issues           Who else       How long
  primary            do it?            needed?           show it was       need to be           should be        will the
 audience?                                               completed?        addressed?           involved?     project take?



Organizations      Steering         Time, recruitment   List of case      None                Community       1 year
and agencies       committee and    materials and       management                            liaisons and
that case man-     Education Work   strategy, meeting   programs                              gatekeepers
agement pro-       Group            times and space
grams that do or
can accommo-
date asthma


      Strategy 3. Educate public health nurses in case management programs about
                        techniques to address asthma.

    Target         Responsible       Anticipated         Measurable        Anticipated        Collaborators       Time
  Population         Person           Resources           Indicator          Barriers                            Frame

 Who is the         Who will            What is          How will you      What issues           Who else       How long
  primary            do it?            needed?           show it was       need to be           should be        will the
 audience?                                               completed?        addressed?           involved?     project take?



Public health      Steering         Time, materials,    Asthma            Territory issues,   Public health   2 years
nurses             committee and    meeting space,      incorporated in   time, no interest   nurses, case
                   Education        media               case manage-      from public         management
                   Work Group       opportunities,      ment programs     health nurses       programs
                                    satellite
                                    conferences




                                                             - 64 -
     3. Goal.       Promote the development and/or recruitment of certified
                    asthma educators in community settings to increase patient
                    education.

      Strategy 1. Promote nationally recognized training in asthma education as the standard
                       for asthma educators.

    Target       Responsible           Anticipated         Measurable          Anticipated        Collaborators           Time
  Population       Person               Resources           Indicator            Barriers                                Frame

  Who is the       Who will               What is          How will you        What issues           Who else          How long
   primary          do it?               needed?           show it was         need to be           should be           will the
  audience?                                                completed?          addressed?           involved?        project take?



Allied health    Illinois Asthma     Time, information   Acceptance of       Money, time,         Education Work     2 years
professionals,   Partnership, work   on certification    and interest in     recruiting           Group, organiza-
asthma           groups              trainings           certification,      participants to be   tion and agen-
educators                                                developed plan      certified            cies that have
                                                         to promote certi-                        potential
                                                         fication                                 participants



      Strategy 2. Identify nationally certified asthma educators who can serve as resources
                       for communities in need.

   Target        Responsible          Anticipated         Measurable          Anticipated         Collaborators          Time
 Population        Person              Resources           Indicator            Barriers                                Frame

 Who is the       Who will               What is          How will you        What issues            Who else          How long
  primary          do it?               needed?           show it was         need to be            should be           will the
 audience?                                                completed?          addressed?            involved?        project take?



Asthma           Education Work      Time, certified     Number of           Territory issues,    LHDs, agencies     3 years
educators        Group               asthma              certified asthma    identifying asth-    with asthma
                                     educators,          educators           ma educators         educators,
                                     identification of   statewide,                               community
                                     communities         compared to                              gatekeepers
                                                         baseline




                                                              - 65 -
      4. Goal. Obtain additional funding to support the state's plan.
      Strategy 1. Identify areas within the plan that need funding to implement strategies.

   Target         Responsible    Anticipated         Measurable           Anticipated         Collaborators         Time
 Population         Person        Resources           Indicator             Barriers                               Frame

 Who is the        Who will        What is           How will you         What issues            Who else         How long
  primary           do it?        needed?            show it was          need to be            should be          will the
 audience?                                           completed?           addressed?            involved?       project take?



Illinois          Steering      Time, meeting       List of strategies   None                 Work group        6 months
Asthma            committee     times to develop    prioritized for                           members
Partnership                     consensus           funding




      Strategy 2. Identify potential sources of funding.

    Target        Responsible    Anticipated          Measurable          Anticipated         Collaborators         Time
  Population        Person        Resources            Indicator            Barriers                               Frame

  Who is the        Who will        What is          How will you         What issues            Who else         How long
   primary           do it?        needed?           show it was          need to be            should be          will the
  audience?                                          completed?           addressed?            involved?       project take?



Illinois Asthma   Steering      Access to list of   List of sources of   Potential barriers   Illinois Asthma   Ongoing
Partnership       committee     potential funding   funding              associated with      Partnership,
                                sources                                  going after grant    organizations
                                                                         funds, competi-      and agencies
                                                                         tion, correctly
                                                                         identifying
                                                                         sources etc.




                                                          - 66 -
      Strategy 3. Develop linkages with potential funding sources.

    Target        Responsible        Anticipated        Measurable        Anticipated      Collaborators         Time
  Population        Person            Resources          Indicator          Barriers                            Frame

 Who is the         Who will            What is         How will you      What issues         Who else         How long
  primary            do it?            needed?          show it was       need to be         should be          will the
 audience?                                              completed?        addressed?         involved?       project take?



Funding sources   Steering          Time, contact to   Linkage made      Time, aiming at   Illinois Asthma   Ongoing
                  committee         linkages,          with potential    interests of      Partnership
                                    proposal           funding source,   funding agen-
                                    developed          proposals         cies, all the
                                                       developed         issues involved
                                                                         in developing
                                                                         proposals


      5. Goal. Establish a steering committee to oversee and evaluate the
         progress of the state's asthma plan.

      Strategy 1. Identify criteria for committee memberships

    Target        Responsible        Anticipated        Measurable        Anticipated      Collaborators         Time
  Population        Person            Resources          Indicator          Barriers                            Frame

 Who is the         Who will            What is         How will you      What issues         Who else         How long
  primary            do it?            needed?          show it was       need to be         should be          will the
 audience?                                              completed?        addressed?         involved?       project take?



Illinois Asthma   Illinois Asthma   Time, volunteers   Criteria          Agreement on      Work group        3 months
Partnership       Partnership                          established       criteria,         members
                                                                         volunteers




                                                            - 67 -
     Strategy 2. Identify and recruit members for steering committee.

   Target     Responsible      Anticipated     Measurable      Anticipated      Collaborators       Time
 Population     Person          Resources       Indicator        Barriers                          Frame

 Who is the     Who will         What is       How will you    What issues         Who else       How long
  primary        do it?         needed?        show it was     need to be         should be        will the
 audience?                                     completed?      addressed?         involved?     project take?



Steering      Illinois        Time, members   Steering        Time and          Work group      6 months
committee     Asthma          to volunteer    committee       commitment from   members
              Partnership                     established     members




     Strategy 3. Convene steering committee at regular intervals to assess progress of
                    the state plan.

   Target     Responsible      Anticipated     Measurable      Anticipated      Collaborators       Time
 Population     Person          Resources       Indicator        Barriers                          Frame

 Who is the     Who will         What is       How will you    What issues         Who else       How long
  primary        do it?         needed?        show it was     need to be         should be        will the
 audience?                                     completed?      addressed?         involved?     project take?



Steering      Illinois        Time, space     Steering        Time and          Illinois        6 months
committee     Asthma                          committee       commitment from   Asthma
              Program                         convened        members           Partnership




                                                  - 68 -
                                        Evaluation




   T
               he evaluation process answers several important questions: "Are the right
               things being done?" and "Are they being done correctly?" There are four
               stages of evaluation: formative, process, impact and outcome. The U.S.
               Department of Health and Human Services defines these stages in its
               document, Demonstrating Your Program's Worth:

   Formative     Process of testing program plans, messages, materials, strategies, or
                 modifications for weaknesses and strengths before they are put into effect.
                 It is also used when an unanticipated problem occurs after the
                 program is in effect.

   Process       The mechanism for testing whether the program's procedures for reaching
                 the target population are working as planned.

   Impact        The process of assessing the program's progress toward its goals (i.e.,
                 measuring the immediate change brought about by the program in the target
                 population).

   Outcome       The process of measuring whether your program met its ultimate goal of
                 reducing morbidity and mortality.

The work groups will oversee evaluation of the goals for their respective topic areas (e.g. the
Data and Surveillance Work Group will oversee evaluation of the data and surveillance goals).
Furthermore, each work group will develop an evaluation plan for the goals it will be work-
ing toward and will address the four stages of evaluation for each goal. The evaluation plans
will be developed prior to the start of the implementation phase of the state plan. The steer-
ing committee will review each of the evaluation plans to provide technical assistance.

The CDC's "Framework for Program Evaluation in Public Health" (MMWR, September 17,
1999, Vol. 48 No. RR-11) will be adopted to provide a structured basis for the evaluations.
Here is an example:

   3.1    Engaging key stakeholders in acceding to the importance of an evaluation by
          assembling an evaluation team and addressing common concerns.
   3.2    Describing the evaluation goals.
          Identifying the evaluation design (understanding utility, feasibility, propriety,
          and accuracy of methods).
          Agreeing on whom will conduct the evaluation.
          Deciding on type of evaluation.
          Focus the evaluation design.
          Selecting measures of effectiveness.
          Decide who to select as respondent.
          Gather credible evidence by selecting measurement methods, developing



                                             - 69 -
          data collection instruments, deciding on sample size, defining time frame for data
          collection, collecting data, analyzing data.
          Interpret data.
          Justify conclusions.
          Reporting results.
          Ensuring use of materials.
          Sharing lessons learned.

The steering committee will oversee the evaluation of the state plan. Meeting at regular
intervals, it will review and discuss the progress of the plan, activities of the work groups and
data issues. The steering committee will report to the Illinois Asthma Partnership
quarterly and prepare an evaluation report annually.




                                              - 70 -
              Sustaining Illinois Asthma Initiatives
The structure of the Illinois Asthma Program (IAP) includes a partnership with over 100
members throughout the state of Illinois, four work groups (Occupational Asthma,
Education, School and Data and Surveillance) and community asthma grants. The Illinois
Asthma Partnership meets quarterly. Three meetings are held via video conference with a site
in Springfield and a site in Chicago, and one meeting is face to face. On an annual basis, the
Illinois Department of Public Health surveys the Illinois Asthma Partnership members. The
purpose of the survey is to get feedback on meeting content, leadership, direction, and
needed topics and focus. Based on the results of the first survey, the Partnership reformatted
and refocused to meet the needs of the members. The members agreed that the Partnership
needed statewide ownership and involvement from members. Two members were
selected as co-chairs of the Partnership to identify concerns or issues regarding the IAP.

Each partner is key to sustaining the Illinois Asthma Partnership. The co-chairs will
continue to coordinate the quarterly meetings. A steering committee will be created to
oversee and evaluate the Asthma State Plan. Members for the Steering Committee will be
selected based on criteria established the Illinois Asthma Partnership. The Asthma
Partnership will serve as the centralized location for asthma resources and information on
projects being implemented throughout the state. The Illinois Department of Public Health
will continue to provide technical assistance to the Asthma Partnership and work groups,
disseminate the annual partnership satisfaction survey, and provide an annual progress
report on the state plan. To supplement this individual partner level of commitment the
sustainability process proposed by the Center for Civic Partnerships will be adopted as a
formal framework to keep the Partnership focused on maintenance (Center for Civic
Partnership Sustainability Tool Kit. 10 Steps to Maintaining Your Community Improvements.
Public Health Institute, Sacramento CA: 2001) In brief, the 10 steps to be followed include:

      1. Create a shared understanding of sustainability within the Partnership.
      2. Set up effort using factors that will help increase odds of sustainability.
      3. Create plan for working through sustainability issues.
      4. Look at the "current picture" on an annual basis.
      5. Determine criteria for deciding what to sustain.
      6. Prioritize what should be sustained.
      7. Create options for how to sustain priority efforts (including funding).
      8. Write sustainability plan.
      9. Implement sustainability plan.
     10. Evaluate effectiveness of sustainability plan (make revisions as needed).

As asthma continues to increase, more and more community asthma consortia are being
formed. The consortia are an important component in the battle against asthma. Their strong
ties to the community, with gatekeepers and key stakeholders often serving as members,
make consortia important liaisons between their communities and the Illinois Asthma
Partnership. Currently, the five consortia are located in Chicago, suburban Cook County,




                                              - 71 -
DuPage County, Lake/McHenry counties, Rockford and the Greater St. Louis Metro East.
They may vary in organizational structure, but they share commons goals: to increase aware-
ness and education about asthma to improve the diagnosis and management of asthma and to
strengthen community resources. Many of the consortia receive a wide variety of resources to
support their growth and development. The Illinois Asthma Program believes that consortia
are powerful and effective mechanisms for implementing change at the community level.
Because of this, the partnership will provide assistance and support the collaborative activities
of the consortia.

To support community efforts to assist in reaching the goals of the state asthma plan, two
types of local grants are proposed. Organization and planning grants will provide "seed
money" for communities wanting to develop a consortium. Areas of the state where asthma-
related activities or resources are limited will be the target for these grants. Implementation
grants will assist established consortia in implementing program activities and evaluations to
support the state plan.

In areas where competing community organizations apply for money, the Illinois Asthma
Program will encourage a collaborative effort.

The Illinois Asthma Partnership work groups have accomplished a great deal and will contin-
ue to build on their successes and on the Partnership's efforts to achieve goals set in the state
plan. The implementation section of the state plan will serve as a blueprint for work group
projects. The Illinois Asthma Partnership will allocate funding for special work group projects
and the groups will continue to identify other possible funding sources for their projects. The
work groups will report on their activities at quarterly partnership meetings and will provide
information on how they are progressing toward plan goals for inclusion in the annual report.

A partnership can be defined as an organization of two or more people or groups working
together for a common purpose. The Illinois Asthma Partnership, created more than three
years ago, continues to recruit new members and to identify new strategies and resources to
accomplish the overarching goal of the state's asthma plan: to reduce the morbidity and
mortality of asthma in Illinois.




                                              - 72 -
Appendix A

 Acronyms




  - 73 -
                                       Acronyms


AAP - American Academy of Pediatrics

ALA - American Lung Association

ACSLGME - Asthma Coalition for the St. Louis Greater Metro East

BRFSS - Behavioral Risk Factor Surveillance Survey

CAC - Chicago Asthma Consortium

CDC - U.S. Centers for Disease Control and Prevention

EPA - Environmental Protection Agency

IAP - Illinois Asthma Partnership

HP2010 - Healthy People 2010

IDHS - Illinois Department of Human Services

IDPH - Illinois Department of Public Health

IHCCCC - Illinois Health Care Cost Containment Council

ISBE - Illinois State Board of Education

LMAC - Lake/McHenry Asthma Consortium

NAEPP - National Asthma Education and Prevention Program

NIH - National Institutes of Health

NHLBI - National Heart Lung and Blood Institute

RAC - Rockford Asthma Coalition

SAC - Suburban Asthma Consortium




                                              - 74 -
       Appendix B

    Healthy People 2010
Asthma - Related Objectives




           - 75 -
                     Healthy People 2010
                 Asthma - Related Objectives
HEALTHY PEOPLE 2010
Asthma Related Objectives

24-1   Reduce asthma deaths.
       24-1a.      Children under age 5 years
       24-1b.      Children aged 5-14 years
       24-1c.      Adolescents and adults aged 15-34 years
       24-1d.      Adults aged 35-64 years
       24-1e.      Adults aged 65 years and older

24-2   Reduce hospitalizations for asthma.
       24-2a.     Children under age 5 years
       24-2b.     Children and adults aged 5 to 64 years
       24-2c.     Adults aged 65 years and older

24-3   Reduce hospital emergency department visits for asthma.
       24-3a.     Children under age 5 years
       24-3b.     Children and adults aged 5 to 64 years
       24-3c.     Adults aged 65 years and older

24-4   Reduce activity limitations among persons with asthma

24-5   (Developmental) Reduce the number of school or work days missed by persons
       with asthma due to asthma.

24-6   Increase the proportion of persons with asthma who receive formal education,
       including information about community and self-help resources, as an essential
       part of the management of their condition.

24-7   (Developmental) Increase the proportion of persons with asthma who receive
       appropriate asthma care according to the NAEPP Guidelines.

       24-7a. Persons with asthma who receive written asthma management plans from
              their health care provider.

       24-7b. Persons with asthma with prescribed inhalers who receive instruction on
              how to use them properly.

       24-7c. Persons with asthma who receive education about recognizing early signs
              and symptoms of asthma episodes and how to respond appropriately, includ-
              ing instruction on peak flow monitoring for those who use daily therapy.




                                         - 76 -
       24-7d. Persons with asthma who receive medication regimens that prevent
              the need for more than one canister of short-acting inhaled beta agonists per
              month for relief of symptoms.

       24-7e. Persons with asthma who receive follow up medical care for long-term
              management of asthma after any hospitalization due to asthma.

       24-7f. Persons with asthma who receive assistance with assessing and reducing
              exposure to environmental risk factors in their home, school, and work
              environments.

24-8   (Developmental) Establish in at least 25 states a surveillance system for
       tracking asthma deaths, illness, disability, impact of occupational and
       environmental factors on asthma, access to medical care, and asthma
       management.




                                          - 77 -
      Appendix C

Illinois Asthma Partner List




           - 78 -
                     Illinois Asthma Partner List
Allergy Indoors.com
American Academy of Pediatrics
American Lung Association of Illinois
American Lung Association of Metro Chicago
Asthma Coalition for the Greater St. Louis Metro East
Aunt Martha's Youth Service Center
Beethoven Elementary School
Center for Children's Environmental Health
Central DuPage Hospital
Chicago Asthma Consortium
Chicago Department of Public Health
Chicago Public Schools
Clay County Health Department
Community Health Council
Cook County Children's Hospital
Cook County Department of Public Health
Cook County Hospital, Division of Adolescent Medicine
Country Club Hills School District #160
Decatur Community Partnership
Department of Children and Family Services
DuPage County Health Department
Fayette County Health Department
Glaxo SmithKline
Health Care Consortium of Illinois
Health Research & Policy Centers at UIC
Healthcare Consortium of Illinois
Hult Education Center
Hygienic Institute
Illinois Coalition for School Based/Linked Health
Illinois Department of Human Services
Illinois Department of Public Aid
Illinois Department of Public Health
Illinois Public Health Association
Illinois Society of Allergy, Asthma & Immunology
Illinois State Board of Education
Knox County Health Department
La Rabida Children's Hospital
Lake County Health Department




                                         - 79 -
Lake/McHenry Asthma Consortium
Loyola University
Macoupin County Health Department
McDonough County Health Department
Memorial Hospital
Mercy-Dunbar Health Center
Michael Reese Hospital, Comprehensive Quality Care
Midwest Occupational Health Associates
Millikin University
Oak Park Department of Public Health
Occupational Safety and Health Administration
Office of Inspector General
Proctor Hospital
Proctor In-School Health
Provena USMC
Rock Island County Health Department
Rockford Asthma Consortium
Rockford College
Rural Health Inc.
Rush-Presbyterian - St. Lukes Medical Center
Safe Effective Alternatives, Inc.
Sangamon County Health Department
Southern Illinois Healthcare Foundation
Southern Illinois University Edwardsville - School of Nursing
Springfield Department of Public Health
Springfield Public Schools
St. Clair County Health Department
St. Johns Hospital
Suburban Asthma Consortium
Trinity Enterprises, Ltd
University of Chicago
University of Illinois Chicago
University of Illinois, School of Medicine, Peoria
University of Illinois, School of Medicine, Rockford
U.S. Environmental Protection Agency
Washington University School of Medicine
Western Illinois University
Will County Community Health Center
Will County Health Department




                                           - 80 -
    Appendix D

Local Asthma Consortia




        - 81 -
                        Local Asthma Consortia
Asthma Coalition for the St. Louis Greater Metro East
American Lung Association
1600 Golfview Drive, Suite 260
Collinsville, IL 62234
Phone 618-344-8891
Fax 618-344-8933

Chicago Asthma Consortium
400 N. May St.
Chicago, IL 60622-6480
Phone 312-243-1560
Fax 312-243-1656
Web page www.chicagoasthma.org

Lake/McHenry Asthma Consortium
1234 Sheridan Road
Winthrop Harbor, IL 60096
Phone 847-757-7560
Fax 847-776-4922

Rockford Asthma Consortium
University of Illinois at Rockford
1601 Parkview
Rockford, IL 61107
Phone 815-395-5701
Fax 815-395-5706

Suburban Asthma Consortium
1749 S. Naperville Road
Wheaton, IL 60187
Phone 630-260-9600
Fax 630-260-1111




                                       - 82 -
       Appendix E

Local Asthma Consortiums Map




           - 83 -
ILLINOIS
ASTHMA                       Rockford
                                        Lake McHenry
                                        Asthma
CONSORTIUMS                   Asthma
                           Consortium
                                        Consortium




                                                       Chicago
                                                       Asthma
                                                       Consortium




                                                   Suburban
                                                   Asthma
                                                   Consortium




 Greater St. Louis Metro
 East Asthma Coalition
      Appendix F

Illinois Call To Action Form




          - 85 -
                         Illinois Asthma Partnership
                                       CALL TO ACTION
"Are you willing to make a sustained commitment in furthering the statewide agenda for
asthma? Are you willing to assist with the implementation of strategies and activities
identified in the state's plan: Addressing Asthma in Illinois?" After reviewing the work plan and your
own organization's mission and goals, please identify at least one work group in which you or a
representative from your organization will participate.

   Data and Surveillance Work Group;
         Identify data sources of local and statewide significance, disseminate and promote use of
         available data, coordinate expansion of data collection, identify and share successful
         local models.

   Schools Work Group;
         Provide effective asthma educational materials and resources to school personnel,
         promote consistent messages in the school community on the management of asthma,
         provide school personnel with the necessary tools to develop strategies and policies to
         support the school community throughout the educational continuum, including day
         care through college, in the management of asthma.

    Occupational Asthma Work Group;
         Assess the burden of asthma in the workplace, provide information to businesses that
         addresses asthma as a public health issue in the workplace, work toward ensuring that
         people affected by asthma in the workplace have access to resources.

   Education Work Group;
         Identify education and training needs of various health professionals, assess successful
         strategies for potential statewide or regional replication, promote the National Heart,
         Lung and Blood Institute guidelines.


   Name:
   Organization:
   Address:
   Phone:                                                FAX:
   E-mail:

   Work groups will meet via conference call. An Illinois Department of Public Health staff
   person will coordinate calls and provide minutes of the calls for each work group.
                                      Please return form to:
                          Illinois Department of Public Health,
                   535 W. Jefferson St., Springfield, Illinois 62761
                                      Fax 217-782-1235

       If you have questions about participating in the state's asthma program, call 217-782-3300.


                                                - 86 -

								
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